Provider Demographics
NPI:1194416602
Name:RUGGIERO, REBECCA (APRN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:RUGGIERO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10855 EUREKA ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4068
Mailing Address - Country:US
Mailing Address - Phone:561-289-5839
Mailing Address - Fax:
Practice Address - Street 1:1750 N UNIVERSITY DR UNIT NO
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8903
Practice Address - Country:US
Practice Address - Phone:954-507-8034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11023837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily