| Patricia Jo Ryan Phd Pa | |
|
422 Trento Drive Venice FL 34285 | |
| (941) 486-1930 | |
| (941) 866-2626 |
| Full Name | Patricia Jo Ryan Phd Pa |
|---|---|
| Speciality | Psychologist |
| Location | 422 Trento Drive, Venice, Florida |
| Authorized Official Name and Position | Patricia Jo Ryan (PSYCHOLGIST) |
| Authorized Official Contact | 9414861930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patricia Jo Ryan Phd Pa 1435 E Venice Ave Unit 104 Pmb #200 Venice FL 34292-3074 Ph: (941) 486-1930 | Patricia Jo Ryan Phd Pa 422 Trento Drive Venice FL 34285 Ph: (941) 486-1930 |
| NPI Number | 1639348188 |
|---|---|
| Provider Enumeration Date | 02/28/2008 |
| Last Update Date | 01/22/2024 |
| Certification Date | 01/17/2024 |
| Medicare PECOS PAC ID | 4385729722 |
|---|---|
| Medicare Enrollment ID | O20080311000069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639348188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY4642 (Florida) | Primary |
| Provider Name | Patricia J Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760544803 PECOS PAC ID: 9133204696 Enrollment ID: I20080307000178 |
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