Provider Demographics
NPI:1225703994
Name:BAY, RYAN SHELDON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:SHELDON
Last Name:BAY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 RIVERSIDE AVE UNIT 633
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-4989
Mailing Address - Country:US
Mailing Address - Phone:863-514-7134
Mailing Address - Fax:
Practice Address - Street 1:2033 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4442
Practice Address - Country:US
Practice Address - Phone:904-381-1162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS62983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist