Provider Demographics
NPI:1851655047
Name:TARASIUK-RUSEK, ANETA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANETA
Middle Name:
Last Name:TARASIUK-RUSEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANETA
Other - Middle Name:
Other - Last Name:RUSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2651 SW 32ND PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7848
Mailing Address - Country:US
Mailing Address - Phone:352-401-7552
Mailing Address - Fax:
Practice Address - Street 1:2651 SW 32ND PL
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7848
Practice Address - Country:US
Practice Address - Phone:352-401-7552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME123634207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL667913Medicaid