Provider Demographics
NPI:1275333924
Name:RUGGLES, ZENDI M (IMH)
Entity type:Individual
Prefix:
First Name:ZENDI
Middle Name:M
Last Name:RUGGLES
Suffix:
Gender:
Credentials:IMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 HANOVER DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-6035
Mailing Address - Country:US
Mailing Address - Phone:727-358-9911
Mailing Address - Fax:727-499-2612
Practice Address - Street 1:1815 HEALTH CARE DR STE B
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-5377
Practice Address - Country:US
Practice Address - Phone:727-358-9911
Practice Address - Fax:727-499-2612
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH27286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health