Provider Demographics
NPI:1477283083
Name:RUILOVA, RALPH M II (PTA)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:M
Last Name:RUILOVA
Suffix:II
Gender:M
Credentials:PTA
Other - Prefix:MR
Other - First Name:RALPH
Other - Middle Name:M
Other - Last Name:RUILOVA
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:2723 W OSBORNE AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7221
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2723 W OSBORNE AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7221
Practice Address - Country:US
Practice Address - Phone:813-347-0349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA17499208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation