Provider Demographics
NPI:1003149691
Name:RUBY, WILLIAM H (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:RUBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34106-0429
Mailing Address - Country:US
Mailing Address - Phone:239-252-8200
Mailing Address - Fax:239-252-8808
Practice Address - Street 1:3339 E TAMIAMI TRL STE 145
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-5361
Practice Address - Country:US
Practice Address - Phone:239-252-8200
Practice Address - Fax:239-252-8808
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10550207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001423600Medicaid
FLCP422ZMedicare PIN