Provider Demographics
NPI:1093769697
Name:ERNESTO J RUAS, MD, PA
Entity Type:Organization
Organization Name:ERNESTO J RUAS, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-259-1550
Mailing Address - Street 1:603 S BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2629
Mailing Address - Country:US
Mailing Address - Phone:813-259-1550
Mailing Address - Fax:813-258-1287
Practice Address - Street 1:603 S BOULEVARD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2629
Practice Address - Country:US
Practice Address - Phone:813-259-1550
Practice Address - Fax:813-258-1287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74886OtherBC/BS
FL3532804OtherAETNA
FL74886OtherBC/BS