Provider Demographics
NPI:1518326966
Name:UHAZIE, RYAN JAMES (PT, DPT, ATC,LAT)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JAMES
Last Name:UHAZIE
Suffix:
Gender:M
Credentials:PT, DPT, ATC,LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 SE THANKSGIVING AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34984-4777
Mailing Address - Country:US
Mailing Address - Phone:772-233-5892
Mailing Address - Fax:
Practice Address - Street 1:317 SE THANKSGIVING AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-4777
Practice Address - Country:US
Practice Address - Phone:772-233-5892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-13
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL4212390200000X
FLPT33870225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program