Individual
MICHAEL RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2415 N ORANGE AVE STE 700, ORLANDO, FL 32804-5521
(407) 303-2474
Mailing address
4584 OLD CARRIAGE TRL, OVIEDO, FL 32765-8473
(407) 701-4253
(407) 679-4343
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2204
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292052200
—
FL
Enumeration date
04/03/2007
Last updated
10/11/2023
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