Individual
PATRICK J RUDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 AVENUE 'B', NW, WINTER HAVEN, FL 33881-4651
(863) 291-4000
Mailing address
PO BOX 917110, ORLANDO, FL 32891-7110
(800) 901-2102
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME67160
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26262
BLUE CROSS BLUE SHIELD FL
FL
05
—
376422200
—
FL
01
—
50056275
RAILROAD MEDICARE
FL
01
—
SSN
TRICARE/CHAMPUS
FL
Enumeration date
06/01/2006
Last updated
08/18/2010
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