| Jacque Ruch, Llc | |
|
3205 Southgate Cir Ste 19 Sarasota FL 34239-5514 | |
| (815) 243-8332 | |
| Not Available |
| Full Name | Jacque Ruch, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3205 Southgate Cir Ste 19, Sarasota, Florida |
| Authorized Official Name and Position | Jacquelyn J Ruch (OWNER) |
| Authorized Official Contact | 8152438332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacque Ruch, Llc 11519 Sweetgrass Dr Bradenton FL 34212-2522 Ph: (815) 243-8332 | Jacque Ruch, Llc 3205 Southgate Cir Ste 19 Sarasota FL 34239-5514 Ph: (815) 243-8332 |
| NPI Number | 1023639499 |
|---|---|
| Provider Enumeration Date | 04/27/2020 |
| Last Update Date | 04/27/2020 |
| Certification Date | 04/27/2020 |
| Medicare PECOS PAC ID | 6305251760 |
|---|---|
| Medicare Enrollment ID | O20210216003132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023639499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jacquelyn J Ruch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407129471 PECOS PAC ID: 3476715111 Enrollment ID: I20200429003119 |
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