Fudala, Ronald D
Fudala, Ronald D is an sole proprietor health care provider with primary practice located at 1301 Plantation Island Dr S Suite 402 A, Saint Augustine FL 32080-3108. He recently has only one registered license in Chiropractic Providers / Neurology, which is considered as his primary health care specialty. Fudala, Ronald D can be contacted via phone (904) 471-4744.Contact Information
Primary practice address
1301 Plantation Island Dr S Suite 402 A
Saint Augustine FL 32080-3108
Phone: (904) 471-4744
Fax: (901) 471-4745
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Neurology | 111NN0400X | 1317 | Ohio |
| Chiropractic Providers / Neurology | 111NN0400X | CH10979 | Florida |
Profile Details
| NPI number | 1447362058 |
|---|---|
| LBN Legal business name | Fudala, Ronald D |
| Credentials | DC,DACAN |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Feb 5th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447362058 | NPPES |
| Other | 000000206217 | ANTHEM | |
| Other | 44-00470 | ANTHEM | |
| Other | 2501109 | ANTHEM |
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