Provider Demographics
NPI:1356958391
Name:RUJIMORA, JOHN-MIKE SATURNO
Entity type:Individual
Prefix:MR
First Name:JOHN-MIKE
Middle Name:SATURNO
Last Name:RUJIMORA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15804 NW 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6697
Mailing Address - Country:US
Mailing Address - Phone:305-528-7448
Mailing Address - Fax:
Practice Address - Street 1:15804 NW 80TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-6697
Practice Address - Country:US
Practice Address - Phone:305-528-7448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730815163W00000X
FLRN9356123163W00000X
VA0024190421367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse