Provider Demographics
NPI:1285891762
Name:LAWLESS, RYAN ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ANTHONY
Last Name:LAWLESS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1335 SLIGH BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1110
Mailing Address - Country:US
Mailing Address - Phone:407-649-6884
Mailing Address - Fax:407-245-7059
Practice Address - Street 1:1335 SLIGH BLVD
Practice Address - Street 2:STE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1110
Practice Address - Country:US
Practice Address - Phone:407-649-6884
Practice Address - Fax:407-245-7059
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME130001208600000X, 2086S0102X
CO191892086S0102X
TXP69912086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL118949200Medicaid
TX327051403 (MDACC)Medicaid
TX8EC499OtherBCBS (MDACC)