Provider Demographics
NPI:1417375619
Name:RORY ADVANCED PRACTICE ASSOCIATES
Entity Type:Organization
Organization Name:RORY ADVANCED PRACTICE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:305-342-5855
Mailing Address - Street 1:1110 WILSHIRE CIR E
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2206
Mailing Address - Country:US
Mailing Address - Phone:305-342-5855
Mailing Address - Fax:954-964-6084
Practice Address - Street 1:1110 WILSHIRE CIR E
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-2206
Practice Address - Country:US
Practice Address - Phone:305-342-5855
Practice Address - Fax:954-964-6084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty