Provider Demographics
NPI:1699052340
Name:RYAN, ELIZABETH BROOKE (ARNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BROOKE
Last Name:RYAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 NW 17TH ST STE 10A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1119
Mailing Address - Country:US
Mailing Address - Phone:305-326-6590
Mailing Address - Fax:305-326-6585
Practice Address - Street 1:901 NW 17TH ST STE 10A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1135
Practice Address - Country:US
Practice Address - Phone:305-326-6590
Practice Address - Fax:305-326-6585
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9256543363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care