Healthcare Provider Details

I. General information

NPI: 1568495331
Provider Name (Legal Business Name): RAYMACK ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6191 ORANGE DR SUITE 4466
DAVIE FL
33314-3449
US

IV. Provider business mailing address

PO BOX 817858
HOLLYWOOD FL
33081-1858
US

V. Phone/Fax

Practice location:
  • Phone: 954-583-5152
  • Fax: 954-583-5142
Mailing address:
  • Phone: 954-583-5152
  • Fax: 954-583-5142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MISS ROBYN DAWN PAPPAS
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 954-583-5152