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General NPI Number Information
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NPI Number | 1659513729
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Entity Type | Individual
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Provider Name | RYAN S. JAWITZ D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 14840 TAMIAMI TRL
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City | NORTH PORT
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State | FL
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Zip | 34287-2701
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Country | US
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Telephone | 941-538-7324
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Fax | 941-564-4080
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Provider Business Mailing Address
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Address Line | 900 VILLAGE SQUARE XING STE 290
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4552
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | OS11606
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License Number State | FL
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