Provider Demographics
NPI:1073544607
Name:ARMSTRONG, RONALD B (PA)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:B
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 N SYKES CREEK PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3490
Mailing Address - Country:US
Mailing Address - Phone:321-459-1446
Mailing Address - Fax:321-456-5195
Practice Address - Street 1:220 N SYKES CREEK PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-3490
Practice Address - Country:US
Practice Address - Phone:321-459-1446
Practice Address - Fax:321-456-5195
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 2653363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS82460Medicare UPIN
FLE2654ZMedicare ID - Type Unspecified