MEDICARE: MR. RYAN URZEN LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH18942	FL

General Provider Information

NPI Number	:	1134714611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RYAN URZEN LMHC

Provider Business Mailing Address
First Line	:	PO BOX 4038
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-4038
Country	:	US
Telephone Number	:	561-570-4810
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 S MILITARY TRAIL
Second Line	:	STE 13 #4038
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442
Country	:	US
Telephone Number	:	561-570-4810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2021
Last Update Date	:	03/06/2024

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