Provider Demographics
NPI:1114228038
Name:RUFFALO, MICHELLE MARIE (LM, CPM)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:RUFFALO
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8326 PINE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33637-1011
Mailing Address - Country:US
Mailing Address - Phone:321-223-6707
Mailing Address - Fax:813-776-3608
Practice Address - Street 1:1845 COLLIER PKWY STE C
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-8718
Practice Address - Country:US
Practice Address - Phone:813-461-3844
Practice Address - Fax:813-776-3608
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW244176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife