DR. WILDER RUCKER (NPI# 1235403742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1235403742 |
Entity Type | Individual |
Full Name | DR. WILDER RUCKER |
Credential | MD |
Practice Address |
3601 Sw 160th Ave Ste 250 Miramar FL 33027-6314 |
Mailing Address |
1276 Dekalb Ave # 4a Brooklyn NY 11221-3204 |
Practice Telephone | 8778667123 |
Mailing Telephone | 7184900738 |
Enumeration Date | 2012-03-01 |
Last Update Date | 2019-06-26 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | 264414 | NY | Allopathic & Osteopathic Physicians |
N | 208600000X | Surgery | 264414 | NY | Allopathic & Osteopathic Physicians |
Y | 208D00000X | General Practice | 000-26-4414 | NY | Allopathic & Osteopathic Physicians |
Street Address |
3601 SW 160TH AVE STE 250 |
City | MIRAMAR |
State | FL |
Zip Code | 33027-6314 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164427811 | William H Cantey | Family Medicine | 3601 Sw 160th Ave Ste 250, Miramar, FL 33027-6314 | 2005-06-18 |
1306225883 | Megan Zimmerly | Family Medicine | 3601 Sw 160th Ave Ste 250, Miramar, FL 33027-6314 | 2015-05-29 |
1902283211 | Emmanuel P Jacob | Family Medicine | 3601 Sw 160th Ave Ste 250, Miramar, FL 33027-6314 | 2015-05-06 |
1801280888 | Ronak Kedia | Family Medicine | 3601 Sw 160th Ave Ste 250, Miramar, FL 33027-6314 | 2015-03-26 |
1619384674 | Susan Shilan Yang | Family Medicine | 3601 Sw 160th Ave Ste 250, Miramar, FL 33027-6314 | 2014-07-22 |
1760897045 | Valerie N Allen | Family Medicine | 3601 Sw 160th Ave Ste 250, Miramar, FL 33027-6314 | 2014-06-25 |
1144654070 | Elton Taylor II | Family Medicine | 3601 Sw 160th Ave Ste 250, Miramar, FL 33027-6314 | 2013-08-27 |
1417214768 | Jonathan James Mcclain | Family Medicine | 3601 Sw 160th Ave Ste 250, Miramar, FL 33027-6314 | 2012-04-11 |
1245520030 | Justin Bhupendra Mahida | Family Medicine | 3601 Sw 160th Ave Ste 250, Miramar, FL 33027-6314 | 2011-04-13 |
1063742740 | Amaury Guerra Gutierrez | Family Medicine | 3601 Sw 160th Ave Ste 250, Miramar, FL 33027 | 2010-01-02 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609474808 | A&d Community Mental Health, LLC | Community/Behavioral Health | 1333 Sw 16th Ave, Pembroke Pines, FL 33027 | 2020-10-12 |
1275172256 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 12681 Miramar Parkway, Miramar, FL 33027 | 2019-12-23 |
1902449424 | Marine M Brown | Nurse Practitioner | 4343 Sw 128th Avenue, Mirmar, FL 33027 | 2019-10-28 |
1427699107 | Suncare Therapy, Inc | Physical Therapist | 111 Grant Palms Dr, Pembroke Pines, FL 33027 | 2019-10-03 |
1245888080 | Nicole Angelique Munoz | Nurse Practitioner | 12600 Pembroke Rd Ste 200, Miramar, FL 33027 | 2019-08-26 |
1770052334 | Katalyst Health, LLC | Family Medicine | 14704 Sw 11 Street, Pembroke Pines, FL 33027 | 2018-11-13 |
1700362076 | Jovani Miguel Gonzalez | Dentist | 3600 Sw 163rd Ave, Miramar, FL 33027 | 2018-07-19 |
1336648310 | Janelle Monique Mitchell | Behavior Technician | 3350 Sw 148th Ave Suite 110, Miramar, FL 33027 | 2018-02-06 |
1437667557 | Elizabeth Connors | Specialist/Technologist | 17089 Sw 16th St, Pembroke Pines, FL 33027 | 2018-01-11 |
1992217806 | Bibi Farida Roberts | Counselor | 3590 Sw 142nd Ave, Miramar, FL 33027 | 2017-11-01 |
Find all providers in zip 33027 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528537693 | Blue Life Medical Center LLC | General Practice | 6272 Miramar Pkwy, Miramar, FL 33023-3942 | 2018-11-19 |
1386159416 | Jodelyn Turenne | General Practice | 11551 Sw 26th St Apt 208, Miramar, FL 33025-7540 | 2017-12-12 |
1275864282 | Cora Investments LLC | General Practice | 11904 Miramar Pkwy, Miramar, FL 33025-7005 | 2010-01-15 |
1821206319 | Victor Adam Jaffe | General Practice | 3100 Sw 145th Ave, Miramar, FL 33027-6610 | 2007-05-18 |
1003911223 | United Baptist Group of Broward | General Practice | 14359 Miramar Pkwy, Suite 347, Miramar, FL 33027-4134 | 2006-09-13 |
1346295862 | Sergio Balcazar | General Practice | 5062 Sw 139 Terr, Miramar, FL 33027 | 2006-05-23 |
1275583528 | United Baptist Group of Broward | General Practice | 14359 Miramar Parkway, Ste 347, Miramar, FL 33027 | 2006-05-10 |
1245838168 | Devoted Medical Group, PC | General Practice | 2801 Sw 149th Ave Ste 100, Miramar, FL 33027-4166 | 2020-10-13 |
1295365252 | Guidner Bien-aime | General Practice | 6245 Miramar Pkwy Ste 102, Miramar, FL 33023-3964 | 2020-01-17 |
1114302841 | Medirectors, LLC | General Practice | 3000 Sw 148th Ave, Suite 215, Miramar, FL 33027-4169 | 2015-07-23 |
Find all providers in MIRAMAR |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.