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General NPI Number Information
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NPI Number | 1407099906
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Entity Type | Individual
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Provider Name | MOLLY RYAN DO
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Gender | Female
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Dates
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Enumeration Date | 04/13/2009
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Last Update Date | 02/09/2020
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Provider Practice Location Address
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Address Line | 1000 SE MONTEREY COMMONS BLVD STE 104
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City | STUART
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State | FL
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Zip | 34996-3327
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Country | US
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Telephone | 772-208-0514
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Fax | 772-223-3639
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Provider Business Mailing Address
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Address Line | 1000 SE MONTEREY COMMONS BLVD STE 104
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City | STUART
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State | FL
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Zip | 34996-3327
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Country | US
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Telephone | 772-208-0514
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Fax | 772-223-3639
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | OS12331
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License Number State | FL
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