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General NPI Number Information
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NPI Number | 1891242467
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Entity Type | Individual
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Provider Name | RYAN EVAN HOESTEN M.A., CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 03/12/2021
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Provider Practice Location Address
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Address Line | 644 FERGUSON DR STE 200
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City | ORLANDO
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State | FL
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Zip | 32805-1023
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Country | US
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Telephone | 866-311-4617
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Fax |
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Provider Business Mailing Address
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Address Line | 1410 CATHERINE ST
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City | ORLANDO
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State | FL
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Zip | 32801-4206
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Country | US
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Telephone | 954-821-8684
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SZ 7715
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA15983
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License Number State | FL
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