Individual
KATIE LYNN RYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
8960 COLONIAL CENTER DR STE 302, FORT MYERS, FL 33905-7810
(239) 343-9700
(239) 343-3965
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9700
(239) 343-3965
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS13949
FL
207RC0000X
Cardiovascular Disease Physician
Primary
OS13949
FL
207RI0011X
Interventional Cardiology Physician
O-1589
ID
390200000X
Student in an Organized Health Care Education/Training Program
UO 3999
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123154100
—
FL
Enumeration date
04/01/2013
Last updated
09/06/2024
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