# J D RUGGIERO MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912912106
- **Authorized official:** DR. JOSEPH DAVID RUGGIERO MD (OWNER)
- **Authorized official phone:** (904) 834-1002

## Contact information

- **Practice address:** 2035 PROFESSIONAL CENTER DR, SUITE A, ORANGE PARK, FL 32073-4492
- **Practice address phone:** (904) 272-3200
- **Practice address fax:** (904) 272-3211
- **Mailing address:** 2035 PROFESSIONAL CENTER DR STE A, ORANGE PARK, FL 32073-4462
- **Mailing address phone:** (904) 579-4692
- **Mailing address fax:** (904) 639-6002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | FL | Yes |

## Other

- **Enumeration date:** 07/29/2006
- **Last updated:** 02/23/2021