Individual
DR. RYAN MICHAEL LUEVANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1147 NW 64TH TER, TERRACE, GAINESVILLE, FL 32605-4218
(352) 333-5168
Mailing address
6134 AVENIDA CHAMNEZ, LA JOLLA, CA 92037-7441
(858) 354-1726
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A166859
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2017
Last updated
12/06/2021
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