Provider Demographics
NPI:1477624245
Name:RYAN & URBACH M.D. P.A.
Entity Type:Organization
Organization Name:RYAN & URBACH M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:407-869-8879
Mailing Address - Street 1:659 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2509
Mailing Address - Country:US
Mailing Address - Phone:407-869-8879
Mailing Address - Fax:407-215-4799
Practice Address - Street 1:659 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2509
Practice Address - Country:US
Practice Address - Phone:407-869-8879
Practice Address - Fax:407-215-4799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42232207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59922ZMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
FLD65213Medicare UPIN