Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ruslan Fedkiv

Individual provider Primary Care Nurse Practitioner · NPI 1366300485

Ruslan Fedkiv is a Nurse Practitioner in Boca Raton, Florida. Qualified in 2024, 2 years ago. Practices with Martin Memorial Medical Center Inc, a 516-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
2
Licensed in
FL
In the registry since
2026
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Practice location Address checks out

18037 Mambo Dr
Boca Raton, FL 33496-4113
Phone: (917) 309-6339
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 11036129 (FL)

Record details

NPI number1366300485
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 15, 2026
Last updated in NPPESJanuary 15, 2026
Certification dateJanuary 15, 2026
Mailing address18037 Mambo Dr, Boca Raton, FL 33496-4113

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Martin Memorial Medical Center Inc — 516 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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