Individual
ANGELA MARIE RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4549 BANNEKA ST, ORLANDO, FL 32811-4862
(321) 872-5782
Mailing address
4549 BANNEKA ST, ORLANDO, FL 32811-4862
(321) 872-5782
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009899400
—
FL
Enumeration date
11/22/2013
Last updated
11/22/2013
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