Provider Demographics
NPI:1457704298
Name:DEVILLA, RUTHMAY (RPT)
Entity Type:Individual
Prefix:
First Name:RUTHMAY
Middle Name:
Last Name:DEVILLA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6756 GIANT OAK LN APT 163
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-3595
Mailing Address - Country:US
Mailing Address - Phone:201-875-8919
Mailing Address - Fax:
Practice Address - Street 1:6756 GIANT OAK LN APT 163
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-3595
Practice Address - Country:US
Practice Address - Phone:201-875-8919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-17
Last Update Date:2016-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 31406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist