Provider Demographics
NPI:1720787641
Name:RUFF, KOURTNEY SYMONE (PA-C)
Entity type:Individual
Prefix:
First Name:KOURTNEY
Middle Name:SYMONE
Last Name:RUFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10902 N 50TH ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2102
Mailing Address - Country:US
Mailing Address - Phone:786-972-2350
Mailing Address - Fax:
Practice Address - Street 1:10902 N 50TH ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-2102
Practice Address - Country:US
Practice Address - Phone:786-972-2350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant