Healthcare Provider Details

I. General information

NPI: 1609034594
Provider Name (Legal Business Name): RYAN F DURKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 SAINT MARY AVE
PENSACOLA FL
32501-1053
US

IV. Provider business mailing address

1613 HARRISON PKWY SUITE 200
SUNRISE FL
33323-2896
US

V. Phone/Fax

Practice location:
  • Phone: 850-226-6801
  • Fax: 877-413-5104
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD37385
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME 116657
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: