Provider Demographics
NPI:1932515343
Name:RAYPAR INC
Entity Type:Organization
Organization Name:RAYPAR INC
Other - Org Name:TRINITY MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
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:863-683-4661
Mailing Address - Street 1:3240 S FLORIDA AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4574
Mailing Address - Country:US
Mailing Address - Phone:863-646-4000
Mailing Address - Fax:863-904-0398
Practice Address - Street 1:3240 S FLORIDA AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4574
Practice Address - Country:US
Practice Address - Phone:863-646-4000
Practice Address - Fax:863-904-0398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-07
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty