Provider Demographics
NPI:1013191774
Name:GARAY, EILEEN (PT)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:GARAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 SW 87TH CT
Mailing Address - Street 2:SUITE 209
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2231
Mailing Address - Country:US
Mailing Address - Phone:305-274-3311
Mailing Address - Fax:305-274-1411
Practice Address - Street 1:9000 SW 87TH CT
Practice Address - Street 2:SUITE 209
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2231
Practice Address - Country:US
Practice Address - Phone:305-274-3311
Practice Address - Fax:305-274-1411
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16957225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist