Ryan John Anderson, PA-C
Physician Assistant, Medical in Orlando, FL. Individual provider (NPI-1).
NPI number1356765366
StatusActive
Last updated in NPPESDec 6, 2023
Details
- NPI
- 1356765366
- Entity type
- Individual (NPI-1)
- Name
- Ryan John Anderson
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 11, 2014
- Certification date
- Dec 6, 2023
- Last updated
- Dec 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA9118182 | FL | Yes |
Practice location
1720 S Orange AveOrlando, FL 32806-2945
Phone 321-842-9000 · Fax 321-842-9368
Mailing address
1720 S Orange AveOrlando, FL 32891-2932
Phone 321-842-9000 · Fax 321-842-9368
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