Provider Demographics
NPI:1336374040
Name:ANTONOWICH, RUTH ANNE (ARNP, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANNE
Last Name:ANTONOWICH
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737A OLIVIA ST
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-6444
Mailing Address - Country:US
Mailing Address - Phone:305-849-1080
Mailing Address - Fax:305-295-9984
Practice Address - Street 1:737A OLIVIA ST
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-6444
Practice Address - Country:US
Practice Address - Phone:305-849-1080
Practice Address - Fax:305-295-9984
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1117502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily