Provider Demographics
NPI:1265667869
Name:MURPHY, TRAVIS RAINEY SR (CST/CFA)
Entity Type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:RAINEY
Last Name:MURPHY
Suffix:SR
Gender:M
Credentials:CST/CFA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 243316
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33424-3316
Mailing Address - Country:US
Mailing Address - Phone:561-737-5042
Mailing Address - Fax:561-737-5045
Practice Address - Street 1:618 SW 2ND AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-4373
Practice Address - Country:US
Practice Address - Phone:561-737-5042
Practice Address - Fax:561-737-5045
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL246ZS0400X246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist