Provider Demographics
NPI:1598954273
Name:WILLIAM F RYLANDER M D P A
Entity Type:Organization
Organization Name:WILLIAM F RYLANDER M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCCOSKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-385-0884
Mailing Address - Street 1:407 S WASHINGTON AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-3500
Mailing Address - Country:US
Mailing Address - Phone:321-385-0884
Mailing Address - Fax:321-385-9578
Practice Address - Street 1:407 S WASHINGTON AVE STE 1
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-3500
Practice Address - Country:US
Practice Address - Phone:321-385-0884
Practice Address - Fax:321-385-9578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59323207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL054035800Medicaid
FL1831266089OtherNPI
1730381641OtherNPI
FL276444000Medicaid
FL1861505463OtherNPI
FL1831266089OtherNPI
FLK3922Medicare PIN
FL12105XMedicare PIN
FL276444000Medicaid
FLU5592AMedicare PIN