Provider Demographics
NPI:1568846335
Name:RAYASA, DEVON (DO)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:RAYASA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 TECH DATA DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-3122
Mailing Address - Country:US
Mailing Address - Phone:727-507-2521
Mailing Address - Fax:
Practice Address - Street 1:5380 TECH DATA DR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3122
Practice Address - Country:US
Practice Address - Phone:727-507-2521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-12
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14810208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist