Provider Demographics
NPI:1407667769
Name:RUFFIN, LEE ANN (BSPT)
Entity type:Individual
Prefix:MRS
First Name:LEE
Middle Name:ANN
Last Name:RUFFIN
Suffix:
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MCLANE RD
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4165
Mailing Address - Country:US
Mailing Address - Phone:850-698-4550
Mailing Address - Fax:
Practice Address - Street 1:15 MCLANE RD
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4165
Practice Address - Country:US
Practice Address - Phone:850-698-4550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist