Healthcare Provider Details

I. General information

NPI: 1164399044
Provider Name (Legal Business Name): RYLEE HUMPHRIES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9304 CAMDEN FIELD PKWY
RIVERVIEW FL
33578-0520
US

IV. Provider business mailing address

10302 MARSH HARBOR WAY APT 3
RIVERVIEW FL
33578-3553
US

V. Phone/Fax

Practice location:
  • Phone: 813-533-2999
  • Fax:
Mailing address:
  • Phone: 813-293-1490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number8285
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: