Provider Demographics
NPI:1619957669
Name:RUSKIN, HOWARD M (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:M
Last Name:RUSKIN
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 1:350 NW 84TH AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1817
Mailing Address - Country:US
Mailing Address - Phone:954-424-9444
Mailing Address - Fax:954-424-7702
Practice Address - Street 1:350 NW 84TH AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1817
Practice Address - Country:US
Practice Address - Phone:954-424-9444
Practice Address - Fax:954-424-7702
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2008-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME130782084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
130005692OtherRAILROAD MEDICARE
FL051153600Medicaid
FL051153600Medicaid
FL91499ZMedicare ID - Type Unspecified