MEDICARE: RACHEL M RAY LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	9421	SC
2	225700000X	Massage Therapist	0019017466	VA
3	225700000X	Massage Therapist	MA96451	FL

General Provider Information

NPI Number	:	1780440990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL M RAY LMT

Provider Business Mailing Address
First Line	:	4902 BRIAR OAKS CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-1706
Country	:	US
Telephone Number	:	407-807-8346
Fax Number	:

Provider Business Practice Location Address
First Line	:	4902 BRIAR OAKS CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-1706
Country	:	US
Telephone Number	:	407-807-8346
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2024
Last Update Date	:	02/26/2024

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