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Contact Information

RUSLAN IVANOV, MD
3600 WASHINGTON ST
HOLLYWOOD, FL33021
 Phone: 954-966-4500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for RUSLAN IVANOV · (Male)

NPI Number 1578537189
Status Active
Credentials MD
Entity Individual
Enumeration date 02/13/2006
Last updated 04/21/2026 - About 1 months ago
Sole proprietor 1 No
Identifiers
  • FL License # ME0077225
  • FL License # ME77225
  • WI License # 103676
  • FL Medicaid 264411800
  • FL Other P00278579 RR MCR
Hospital affiliation(s)
  • LEESBURG REGIONAL MEDICAL CENTER - (Acute Care)
    600 E DIXIE AVE
    LEESBURG, FL 34748
  • VILLAGES REGIONAL HOSPITAL THE - (Acute Care)
    1451 EL CAMINO REAL
    THE VILLAGES, FL 32159
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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