Provider Demographics
NPI:1598901613
Name:S P RYAN INC
Entity Type:Organization
Organization Name:S P RYAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:863-386-5044
Mailing Address - Street 1:3269 E ANGLERS STRM
Mailing Address - Street 2:
Mailing Address - City:AVON PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33825-6020
Mailing Address - Country:US
Mailing Address - Phone:863-386-5044
Mailing Address - Fax:863-386-5044
Practice Address - Street 1:3269 E ANGLERS STRM
Practice Address - Street 2:
Practice Address - City:AVON PARK
Practice Address - State:FL
Practice Address - Zip Code:33825-6020
Practice Address - Country:US
Practice Address - Phone:863-386-5044
Practice Address - Fax:863-386-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9260092367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty