Individual
DR. RYAN ABBOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1771
Mailing address
3300 S FISKE BLVD, CREDENTIALING, ROCKLEDGE, FL 32955-4306
(321) 434-1981
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME130933
FL
208M00000X
Hospitalist Physician
Primary
ME130933
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020852400
—
FL
01
—
PENDING
MEDICARE
FL
Enumeration date
04/04/2014
Last updated
10/11/2023
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