Healthcare Provider Details

I. General information

NPI: 1265728273
Provider Name (Legal Business Name): CHRISTY LAUREN RYAN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD STE 101
TAMPA FL
33612-4745
US

IV. Provider business mailing address

819 MORNING STAR DR
LAKELAND FL
33810-8110
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-2000
  • Fax:
Mailing address:
  • Phone: 352-585-0819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT26531
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: