Provider Demographics
NPI:1710760525
Name:RUGGIERI, MARY NICOLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:NICOLE
Last Name:RUGGIERI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11466 SUMTER GROVE WAY UNIT 9111
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-8889
Mailing Address - Country:US
Mailing Address - Phone:216-870-7830
Mailing Address - Fax:
Practice Address - Street 1:3200 BAILEY LN STE 111
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-8506
Practice Address - Country:US
Practice Address - Phone:239-431-9650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT40627208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation