| Ryan White | |
|
1505 Delaware Ave Fort Pierce FL 34950-3975 | |
| (772) 461-1402 | |
| (772) 461-9972 |
| Full Name | Ryan White |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 1505 Delaware Ave, Fort Pierce, Florida |
| Authorized Official Name and Position | Michael F Gervasi (PRESIDENT & CEO) |
| Authorized Official Contact | 5618449443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ryan White 5827 Corporate Way West Palm Beach FL 33407-2000 Ph: (561) 844-9443 | Ryan White 1505 Delaware Ave Fort Pierce FL 34950-3975 Ph: (772) 461-1402 |
| NPI Number | 1023210853 |
|---|---|
| Provider Enumeration Date | 06/04/2007 |
| Last Update Date | 06/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023210853 | NPI | - | NPPES |
| 029574401 | Medicaid | FL |
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