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Contact Information

MICHAEL RUCKER II, PA-C
1893 KINGSLEY AVE
STE A
ORANGE PARK, FL32073
 Phone: 904-592-4940
 Fax: 904-400-6673
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MICHAEL RUCKER II · (Male)

NPI Number 1083107965
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 06/14/2018
Last updated 11/07/2018 - About 11 months ago
Sole proprietor 1 No
Identifiers
  • FL License # PA9111567
Hospital affiliation(s)
  • ORANGE PARK MEDICAL CENTER - (Acute Care)
    2001 KINGSLEY AVE
    ORANGE PARK, FL 32073
  • ST VINCENT'S MEDICAL CENTER - (Acute Care)
    1 SHIRCLIFF WAY
    JACKSONVILLE, FL 32204
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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