Healthcare Provider Details

I. General information

NPI: 1275451254
Provider Name (Legal Business Name): JANNY C RAYMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 COLONIAL DR STE 101
MARGATE FL
33063-5672
US

IV. Provider business mailing address

3342 NW 69TH ST
FORT LAUDERDALE FL
33309-1212
US

V. Phone/Fax

Practice location:
  • Phone: 954-978-4180
  • Fax:
Mailing address:
  • Phone: 954-861-9609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number44008
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: