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General NPI Number Information
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NPI Number | 1053728881
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Entity Type | Organization
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Legal Business Name | RAYPAR INC
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Dates
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Enumeration Date | 07/14/2014
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Last Update Date | 07/14/2014
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Provider Practice Location Address
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Address Line | 2140 E EDGEWOOD DR
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City | LAKELAND
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State | FL
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Zip | 33803-3604
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Country | US
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Telephone | 863-669-1212
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Fax | 863-666-6089
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Provider Business Mailing Address
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Address Line | 2140 E EDGEWOOD DR
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City | LAKELAND
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State | FL
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Zip | 33803-3604
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Country | US
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Telephone | 863-669-1212
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Fax | 863-666-6089
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DOROTHY J RAY
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Credential | M.D.
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Telephone | 863-669-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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