Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | ME109627 | FL |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | ME109627 | FL |
NPI | 1154389542 |
---|---|
Provider Name | Dr. Christopher P Ruisi |
First Address | Jacksonville, FL 32203-3667 |
Second Address | Jacksonville, FL 32207-8344 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 16/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003842900 | (05) | FL |
P00965190 | RAILROAD MEDICARE (01) | FL |