Provider Demographics
NPI:1235132549
Name:RUA, IGNACIO (MD)
Entity Type:Individual
Prefix:DR
First Name:IGNACIO
Middle Name:
Last Name:RUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 N. KENDALL DRIVE
Mailing Address - Street 2:SUITE 504-W
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2144
Mailing Address - Country:US
Mailing Address - Phone:305-274-2030
Mailing Address - Fax:305-279-0878
Practice Address - Street 1:8950 N. KENDALL DRIVE
Practice Address - Street 2:SUITE 504-W
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2144
Practice Address - Country:US
Practice Address - Phone:305-274-2030
Practice Address - Fax:305-279-0878
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-0066659208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0005060OtherNEIGHBORHOOD HEALTH PLAN
FL378835-100Medicaid
FL232462OtherAVMED
FL853309OtherAETNA
FL17-02166OtherUNITED HEALTHCARE
FL172278OtherJACKSON MEMORIAL
FL1673686001OtherCIGNA
FL26637OtherBLUE SHIELD
FL26637XMedicare PIN
FL853309OtherAETNA