Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW244 | FL |
NPI | 1114228038 |
---|---|
Provider Name | Michelle Marie Ruffalo |
First Address | Titusville, FL 32780-8305 |
Second Address | Titusville, FL 32780-8305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2010 |
Last Update Date | 09/11/2010 |