Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME62841 | FL |
Y | 2080P0208X | Pediatric Infectious Diseases | ME62841 | FL |
NPI | 1336171180 |
---|---|
Provider Name | Dr. Kathleen A. Ryan |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 23/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
371221400 | (05) | FL |
F40407 | (02) |