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NPI Code Detail

MEDICARE: RYAN C CASPOLI PA-C

MEDICARE: RYAN C CASPOLI PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantFL

General Provider Information

NPI Number : 1639849490
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN C CASPOLI PA-C
Provider Business Mailing Address
First Line : 425 W COLONIAL DR STE 303
Second Line :
City : ORLANDO
State : FL
Zip : 32804-6863
Country : US
Telephone Number : 833-702-8383
Fax Number : 689-304-0303
Provider Business Practice Location Address
First Line : 1215 DUNN AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32218-6330
Country : US
Telephone Number : 904-757-1998
Fax Number : 833-941-1583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2021
Last Update Date : 04/09/2026

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Directions to “ RYAN C CASPOLI PA-C” Practice Location

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