MEDICARE: RAYPAR INC

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	111N00000X	Chiropractor
2	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356374466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAYPAR INC

Provider Business Mailing Address
First Line	:	550 POPE AVE NW
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4679
Country	:	US
Telephone Number	:	863-299-2636
Fax Number	:	863-662-5288

Provider Business Practice Location Address
First Line	:	550 POPE AVE NW
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4679
Country	:	US
Telephone Number	:	863-299-2636
Fax Number	:	863-662-5288

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DOROTHY J RAY
Credential	:	MD
Telephone Number	:	863-683-4661

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	01/03/2019

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Directions to “RAYPAR INC ” Practice Location

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