Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | ME0073282 | FL |
Y | 207R00000X | Internist | ME73282 | FL |
Y | 111NI0900X | Internist | ME73282 | FL |
NPI | 1124022058 |
---|---|
Provider Name | Dr. Peter Ruggiero |
First Address | Longwood, FL 32750-4986 |
Second Address | Longwood, FL 32750-4986 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 24/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F23122 | (02) |