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General NPI Number Information
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NPI Number | 1780438226
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Entity Type | Individual
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Provider Name | RYAN NURGE HIS
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Gender | Male
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Dates
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Enumeration Date | 04/12/2024
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 1519 DALE MABRY HWY STE 105
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City | LUTZ
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State | FL
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Zip | 33548-3033
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Country | US
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Telephone | 813-949-1331
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Fax | 704-251-6746
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Provider Business Mailing Address
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Address Line | 149 PLANTATION RIDGE DR STE 140
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City | MOORESVILLE
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State | NC
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Zip | 28117-9175
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Country | US
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Telephone | 704-360-4788
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Fax | 704-251-6746
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 5779
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License Number State | FL
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