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General NPI Number Information
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NPI Number | 1497168751
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Entity Type | Individual
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Provider Name | JONATHAN RYAN OBI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 311 9TH ST N STE 308
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City | NAPLES
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State | FL
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Zip | 34102-5889
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Country | US
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Telephone | 239-624-4650
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8569
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City | NAPLES
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State | FL
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Zip | 34101-8569
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Country | US
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Telephone |
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | TRN20809
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME128864
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License Number State | FL
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