Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS10550 | FL |
NPI | 1003149691 |
---|---|
Provider Name | Dr. William H Ruby |
First Address | Naples, FL 34106-0429 |
Second Address | Naples, FL 34112-5361 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2009 |
Last Update Date | 24/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001423600 | (05) | FL |