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Organization
ODEL RUANO M D P A
Active
Organization
ODEL RUANO M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ODEL RUANO MD (PRESIDENT)
(941) 258-3606
Entity
Organization
Contact information
Practice address
3067 TAMIAMI TRL, UNIT 3, PORT CHARLOTTE, FL 33952-6601
(941) 258-3606
(941) 258-3370
Mailing address
PO BOX 380639, MURDOCK, FL 33938-0639
(941) 258-3606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64255
BCBS FL
—
Enumeration date
08/21/2007
Last updated
04/30/2008
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