Provider Demographics
NPI:1255418711
Name:MASSE, RAYMOND EARL (MSPT)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:EARL
Last Name:MASSE
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 LAKE DASHA TER
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3121
Mailing Address - Country:US
Mailing Address - Phone:954-288-8667
Mailing Address - Fax:
Practice Address - Street 1:8700 LAKE DASHA TER
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3121
Practice Address - Country:US
Practice Address - Phone:954-288-8667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 20568225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist