Provider Demographics
NPI:1528583713
Name:MAYOR, EUMIR JUNO CRUZ (PT)
Entity Type:Individual
Prefix:
First Name:EUMIR JUNO
Middle Name:CRUZ
Last Name:MAYOR
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 1:306 RAYS MILL ROAD
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315
Mailing Address - Country:US
Mailing Address - Phone:954-440-9898
Mailing Address - Fax:
Practice Address - Street 1:2051 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-3203
Practice Address - Country:US
Practice Address - Phone:704-694-4106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16760225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist