Provider Demographics
NPI:1114218773
Name:ACTION DISABILITY RESOURCES
Entity Type:Organization
Organization Name:ACTION DISABILITY RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-777-1979
Mailing Address - Street 1:5609 TIMUQUANA RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-8054
Mailing Address - Country:US
Mailing Address - Phone:904-777-1979
Mailing Address - Fax:904-771-0150
Practice Address - Street 1:5609 TIMUQUANA RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-8054
Practice Address - Country:US
Practice Address - Phone:904-777-1979
Practice Address - Fax:904-771-0150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1735580000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies