Provider Demographics
NPI:1437488780
Name:VILLAFLOR, RYANDELL DE VERA (PT)
Entity Type:Individual
Prefix:
First Name:RYANDELL
Middle Name:DE VERA
Last Name:VILLAFLOR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 CLEVELAND AVE STE 201205
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-5850
Mailing Address - Country:US
Mailing Address - Phone:239-362-3314
Mailing Address - Fax:239-362-3655
Practice Address - Street 1:2665 CLEVELAND AVE STE 201205
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-5850
Practice Address - Country:US
Practice Address - Phone:239-362-3314
Practice Address - Fax:239-362-3655
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031479-1225100000X
FLPT31443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist