Provider Demographics
NPI:1215157136
Name:SATPATHY, RUBY (MD)
Entity type:Individual
Prefix:DR
First Name:RUBY
Middle Name:
Last Name:SATPATHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43667
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32203-3667
Mailing Address - Country:US
Mailing Address - Phone:904-224-5189
Mailing Address - Fax:904-725-1622
Practice Address - Street 1:836 PRUDENTIAL DR
Practice Address - Street 2:SUITE 1700B
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8334
Practice Address - Country:US
Practice Address - Phone:904-398-0125
Practice Address - Fax:904-398-1832
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23933207RI0011X
IA36898207RI0011X
FLME126231207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098684110OtherMEDICARE PTAN
FL016187600Medicaid
IA414530034OtherMEDICARE PTAN
FLP01573016OtherRR MEDICARE
FLIJ812ZMedicare PIN