Provider Demographics
NPI:1538676366
Name:FLOYD, RYAN WESLEY (ARNP)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:WESLEY
Last Name:FLOYD
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 WOODBINE RD STE A
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-8791
Mailing Address - Country:US
Mailing Address - Phone:850-450-4596
Mailing Address - Fax:
Practice Address - Street 1:4225 WOODBINE RD
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-8790
Practice Address - Country:US
Practice Address - Phone:850-994-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-02
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9337428363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care