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General NPI Number Information
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NPI Number | 1780698001
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Entity Type | Individual
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Provider Name | RYAN K KRASNOSKY PAC
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Gender | Male
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 5153 N 9TH AVE
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City | PENSACOLA
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State | FL
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Zip | 32504-8785
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Country | US
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Telephone | 850-505-4700
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Fax | 850-505-4711
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Provider Business Mailing Address
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Address Line | PO BOX 568908
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City | ORLANDO
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State | FL
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Zip | 32856-8908
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Country | US
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Telephone | 850-505-4700
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Fax | 407-650-7030
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9101760
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9101760
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9101760
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License Number State | FL
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