Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CH6420 | FL |
NPI | 1003833690 |
---|---|
Provider Name | Dr. Paul Joseph Ruggiano |
First Address | Miami, FL 33155-5015 |
Second Address | Miami, FL 33129-1492 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U43196 | (02) | FL |