Provider Demographics
NPI:1215077441
Name:RONIE J. ZARUCHES, O.D., LLC
Entity type:Organization
Organization Name:RONIE J. ZARUCHES, O.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARUCHES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-789-3868
Mailing Address - Street 1:142 POWERLINE ROAD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442
Mailing Address - Country:US
Mailing Address - Phone:561-789-3868
Mailing Address - Fax:
Practice Address - Street 1:142 POWERLINE ROAD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-5006
Practice Address - Country:US
Practice Address - Phone:561-789-3868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2462261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0669720002OtherMEDICARE DMEPOS
FL078900300Medicaid
FLU10122Medicare UPIN
FL20225Medicare ID - Type Unspecified