MEDICARE: TRYAN FUNCTIONAL HEALTH SOLUTIONS LLC

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1811849763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRYAN FUNCTIONAL HEALTH SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	1419 BELLADONNA PL
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-5813
Country	:	US
Telephone Number	:	689-318-5270
Fax Number	:

Provider Business Practice Location Address
First Line	:	1419 BELLADONNA PL
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-5813
Country	:	US
Telephone Number	:	689-318-5270
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TERESITA RYAN
Credential	:	APRN
Telephone Number	:	689-318-5270

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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