Provider Demographics
NPI:1912183203
Name:RAYA, MICHELE ALEXANDRIA (PHD, PT, SCS, ATC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ALEXANDRIA
Last Name:RAYA
Suffix:
Gender:F
Credentials:PHD, PT, SCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 PONCE DE LEON BLVD
Mailing Address - Street 2:5TH FLOOR, PLUMER BLDG
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2435
Mailing Address - Country:US
Mailing Address - Phone:305-284-4711
Mailing Address - Fax:305-284-6128
Practice Address - Street 1:5915 PONCE DE LEON BLVD
Practice Address - Street 2:5TH FLOOR, PLUMER BLDG
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2435
Practice Address - Country:US
Practice Address - Phone:305-284-4711
Practice Address - Fax:305-284-6128
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7033225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist