Provider Demographics
NPI:1659514735
Name:RUGOIYO, FLORENCE W (PTA)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:W
Last Name:RUGOIYO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CLEMENTINE CT APT 3D
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-2273
Mailing Address - Country:US
Mailing Address - Phone:410-866-2967
Mailing Address - Fax:
Practice Address - Street 1:7232 GERMAN HILL RD
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-1260
Practice Address - Country:US
Practice Address - Phone:410-282-6310
Practice Address - Fax:410-282-0321
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA3317225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR200255865944OtherDRIVER'S LICENSE