Provider Demographics
NPI:1578852455
Name:RICH, RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:RICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 N UNIVERSITY DR STE 720
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2009
Mailing Address - Country:US
Mailing Address - Phone:954-473-6750
Mailing Address - Fax:954-424-7093
Practice Address - Street 1:261 N UNIVERSITY DR STE 720
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2009
Practice Address - Country:US
Practice Address - Phone:954-473-6750
Practice Address - Fax:954-424-7093
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2023-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR7956207N00000X
OH35.123527207N00000X
NY276777390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology