MEDICARE: RHYAN FERMIN FLORENDO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	026675	NY

General Provider Information

NPI Number	:	1063584514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHYAN FERMIN FLORENDO

Provider Business Mailing Address
First Line	:	9748 64TH AVE FL 2
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-2231
Country	:	US
Telephone Number	:	510-367-7730
Fax Number	:

Provider Business Practice Location Address
First Line	:	9748 64TH AVE FL 2
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-2231
Country	:	US
Telephone Number	:	510-367-7730
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	03/07/2012

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Directions to “ RHYAN FERMIN FLORENDO ” Practice Location

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