Provider Demographics
NPI:1639434830
Name:RAYO, MA CECILIA
Entity Type:Individual
Prefix:
First Name:MA CECILIA
Middle Name:
Last Name:RAYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 TALON-TALON
Mailing Address - Street 2:
Mailing Address - City:ZAMBOANGA CITY
Mailing Address - State:FOREIGN PROVINCE
Mailing Address - Zip Code:7000
Mailing Address - Country:PH
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16089 POPPYSEED CIR UNIT 2008
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6314
Practice Address - Country:US
Practice Address - Phone:561-496-7993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018061225100000X
NY0325281225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist