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Individual
MR. MICHAEL TIMOTHY RYAN
Active
Individual
MR. MICHAEL TIMOTHY RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT17770
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113534600
—
FL
01
—
611414091
TAX ID
FL
01
—
P00088453
RR MCR #
FL
01
—
PT17770
PT STATE LICENSE #
FL
01
—
Y7549
BCBS #
FL
Enumeration date
10/11/2006
Last updated
10/24/2025
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