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NPI Code Detail

MEDICARE: SEAN D RYAN PA-C

MEDICARE: SEAN D RYAN PA-C
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
1363AM0700XMedical Physician AssistantPA2751FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992789655
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN D RYAN PA-C
Provider Business Mailing Address
First Line : 1500 LEE BLVD
Second Line : LEHIGH REGIONAL MEDICAL CENTER
City : LEHIGH ACRES
State : FL
Zip : 33936-4835
Country : US
Telephone Number : 239-369-2101
Fax Number : 239-368-4510
Provider Business Practice Location Address
First Line : 1500 LEE BLVD
Second Line : LEHIGH REGIONAL MEDICAL CENTER
City : LEHIGH ACRES
State : FL
Zip : 33936-4835
Country : US
Telephone Number : 239-369-2101
Fax Number : 239-368-4510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2005
Last Update Date : 11/10/2011

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Directions to “ SEAN D RYAN PA-C” Practice Location

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