Provider Demographics
NPI:1093990947
Name:ANGARAN, RUTH S (MED, MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:S
Last Name:ANGARAN
Suffix:
Gender:F
Credentials:MED, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 NW 43RD ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6675
Mailing Address - Country:US
Mailing Address - Phone:352-378-0900
Mailing Address - Fax:
Practice Address - Street 1:2610 NW 43RD ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6675
Practice Address - Country:US
Practice Address - Phone:352-378-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW77541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU5754AMedicare PIN