Provider Demographics
NPI:1497462246
Name:CHEEK, RYAN CORBIN (NP-C)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:CORBIN
Last Name:CHEEK
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N MAITLAND AVE UNIT 941828
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5515
Mailing Address - Country:US
Mailing Address - Phone:386-631-1111
Mailing Address - Fax:
Practice Address - Street 1:151 N MAITLAND AVE UNIT 941828
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5515
Practice Address - Country:US
Practice Address - Phone:386-631-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL661239363LF0000X
FL11022842363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily