Individual
MR. BRADLEY S RUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
11528 US HIGHWAY 19, PORT RICHEY, FL 34668-1442
(727) 868-2151
Mailing address
11528 US HIGHWAY 19, PORT RICHEY, FL 34668-1442
(727) 868-2151
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704325400
MI
363LF0000X
Family Nurse Practitioner
APRN.CNP.020108
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN9488436
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700336781
—
MI
05
—
PENDING
—
OH
Enumeration date
10/13/2016
Last updated
03/17/2019
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