Healthcare Provider Details

I. General information

NPI: 1316434939
Provider Name (Legal Business Name): EVA RYDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2018
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20900 BISCAYNE BLVD
AVENTURA FL
33180-1495
US

IV. Provider business mailing address

832 SWEETWATER ISLAND CIR
LONGWOOD FL
32779-2345
US

V. Phone/Fax

Practice location:
  • Phone: 305-682-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME152040
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: