Healthcare Provider Details

I. General information

NPI: 1841844321
Provider Name (Legal Business Name): RYAN CHRISTOPHER HUHN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 S ORANGE AVE
ORLANDO FL
32806-1249
US

IV. Provider business mailing address

4370 TIDEWATER DR
ORLANDO FL
32812-7952
US

V. Phone/Fax

Practice location:
  • Phone: 407-437-5210
  • Fax:
Mailing address:
  • Phone: 407-437-5210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number24537
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: