Healthcare Provider Details

I. General information

NPI: 1265426225
Provider Name (Legal Business Name): YVETTE M RYAN-GREEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YVETTE M MCCREA-RYAN

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 RYANT BLVD
SEBRING FL
33872-4075
US

IV. Provider business mailing address

PO BOX 3702
SEBRING FL
33871-3702
US

V. Phone/Fax

Practice location:
  • Phone: 863-471-1413
  • Fax: 863-471-1416
Mailing address:
  • Phone: 863-471-1413
  • Fax: 863-471-1416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME73833
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: