MEDICARE: KRISTINE ANN RYNN PA

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
1	207P00000X	Emergency Medicine Physician	PA9101505	FL
2	363AM0700X	Medical Physician Assistant	PA9101505	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00331050	OTHER	FL	RAILROAD MEDICARE - FLAGL

General Provider Information

NPI Number	:	1831142330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE ANN RYNN PA

Provider Business Mailing Address
First Line	:	734 ELKCAM BLVD
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32725-2626
Country	:	US
Telephone Number	:	386-532-8200
Fax Number	:	386-774-6862

Provider Business Practice Location Address
First Line	:	734 ELKCAM BLVD
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32725-2626
Country	:	US
Telephone Number	:	386-532-8200
Fax Number	:	386-774-6862

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	04/29/2025

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Directions to “ KRISTINE ANN RYNN PA” Practice Location

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