Individual
JASON A RAVANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
300 SE HOSPITAL AVE, STUART, FL 34994-2338
(772) 223-5945
Mailing address
367 S. GULPH RD, ATTN: IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(561) 333-4000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS8319
FL
Other
Enumeration date
05/19/2006
Last updated
02/14/2019
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