Provider Demographics
NPI:1720013337
Name:RAYPAR INC
Entity Type:Organization
Organization Name:RAYPAR INC
Other - Org Name:OWL NOW URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-669-1212
Mailing Address - Street 1:3240 S FLORIDA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4574
Mailing Address - Country:US
Mailing Address - Phone:863-644-7337
Mailing Address - Fax:863-904-0398
Practice Address - Street 1:3240 S FLORIDA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4574
Practice Address - Country:US
Practice Address - Phone:863-644-7337
Practice Address - Fax:863-904-0398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273368400Medicaid
B905UOtherBLUE CROSS B SHIELD #