Healthcare Provider Details

I. General information

NPI: 1679989164
Provider Name (Legal Business Name): RAYPAR INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 07/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 POPE AVE NW SUITE 200
WINTER HAVEN FL
33881-4679
US

IV. Provider business mailing address

550 POPE AVE NW SUITE 200
WINTER HAVEN FL
33881-4679
US

V. Phone/Fax

Practice location:
  • Phone: 863-299-2630
  • Fax: 863-969-0721
Mailing address:
  • Phone: 863-299-2630
  • Fax: 863-969-0721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DOROTHY J RAY
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 863-669-1212