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General NPI Number Information
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NPI Number | 1437488780
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Entity Type | Individual
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Provider Name | RYANDELL DE VERA VILLAFLOR PT
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Gender | Male
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Dates
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Enumeration Date | 12/16/2009
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 2665 CLEVELAND AVE STE 201205
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City | FORT MYERS
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State | FL
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Zip | 33901-5850
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Country | US
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Telephone | 239-362-3314
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Fax | 239-362-3655
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Provider Business Mailing Address
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Address Line | 2665 CLEVELAND AVE STE 201205
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City | FORT MYERS
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State | FL
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Zip | 33901-5850
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Country | US
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Telephone | 239-362-3314
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Fax | 239-362-3655
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 031479-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT31443
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License Number State | FL
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