Ivanov, Ruslan

Ivanov, Ruslan is an individual health care provider with primary practice located at 3600 Washington St , Hollywood FL 33021. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Ivanov, Ruslan can be contacted via phone (954) 966-4500.

Contact Information

Primary practice address
3600 Washington St Hollywood FL 33021
Phone: (954) 966-4500
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME0077225 Florida
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ME77225 Florida

Profile Details

NPI number 1578537189
LBN Legal business name Ivanov, Ruslan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Aug 23rd, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578537189 NPPES
Florida MEDICAID 264411800
Florida Other P00278579

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