Provider Demographics
NPI:1265426225
Name:RYAN-GREEN, YVETTE M (MD)
Entity type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:M
Last Name:RYAN-GREEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YVETTE
Other - Middle Name:M
Other - Last Name:MCCREA-RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3702
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33871-3702
Mailing Address - Country:US
Mailing Address - Phone:863-471-1413
Mailing Address - Fax:863-471-1416
Practice Address - Street 1:9 RYANT BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-4075
Practice Address - Country:US
Practice Address - Phone:863-471-1413
Practice Address - Fax:863-471-1416
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73833207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252541100Medicaid
FL41638OtherBLUE CROSS BLUE SHIELD
FL41638OtherBLUE CROSS BLUE SHIELD
FLG55381Medicare UPIN