Provider Demographics
NPI:1033609607
Name:DOROY, CYRUS IMMANUEL MACALISANG (PT)
Entity Type:Individual
Prefix:MR
First Name:CYRUS IMMANUEL
Middle Name:MACALISANG
Last Name:DOROY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:336 BROAD ST # 203
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3006
Mailing Address - Country:US
Mailing Address - Phone:352-989-5838
Mailing Address - Fax:352-404-8979
Practice Address - Street 1:1804 OAKLEY SEAVER DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1925
Practice Address - Country:US
Practice Address - Phone:352-989-5838
Practice Address - Fax:352-404-8979
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT33529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist