Provider Demographics
NPI:1891487187
Name:WOELFFER, RYAN SAMUEL (DO6335,ABONCLE201114)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:SAMUEL
Last Name:WOELFFER
Suffix:
Gender:M
Credentials:DO6335,ABONCLE201114
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 SW COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-5713
Mailing Address - Country:US
Mailing Address - Phone:352-873-1000
Mailing Address - Fax:
Practice Address - Street 1:3921 SW COLLEGE RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5713
Practice Address - Country:US
Practice Address - Phone:352-873-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO6653156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician