Provider Demographics
NPI:1841769858
Name:RAZANAUSKAITE, RUTA
Entity Type:Individual
Prefix:
First Name:RUTA
Middle Name:
Last Name:RAZANAUSKAITE
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 1:4230 NE 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-7318
Mailing Address - Country:US
Mailing Address - Phone:561-779-5938
Mailing Address - Fax:
Practice Address - Street 1:211 S NARCISSUS AVE # MU3
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5654
Practice Address - Country:US
Practice Address - Phone:561-790-8256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33864225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist