Provider Demographics
NPI:1669480281
Name:UNGARO, RUBEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:A
Last Name:UNGARO
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 1:1880 E COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3747
Mailing Address - Country:US
Mailing Address - Phone:954-771-8495
Mailing Address - Fax:954-771-8497
Practice Address - Street 1:1880 E COMMERCIAL BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3747
Practice Address - Country:US
Practice Address - Phone:954-771-8495
Practice Address - Fax:954-771-8497
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME31942174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL93475Medicare ID - Type Unspecified
FLD60500Medicare UPIN