Healthcare Provider Details

I. General information

NPI: 1972036184
Provider Name (Legal Business Name): RYAN ALEXANDER DAVIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2699 LEE RD STE 100
WINTER PARK FL
32789-1738
US

IV. Provider business mailing address

25 W CRYSTAL LAKE ST STE 200
ORLANDO FL
32806-4476
US

V. Phone/Fax

Practice location:
  • Phone: 407-897-1363
  • Fax: 407-897-1384
Mailing address:
  • Phone: 407-254-2500
  • Fax: 407-423-2789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME168222
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberME168222
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: