Provider Demographics
NPI:1841268356
Name:VAN KUIJK, RAYMOND (PT)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:VAN KUIJK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 SEVERS LNDG
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-6243
Mailing Address - Country:US
Mailing Address - Phone:727-785-0016
Mailing Address - Fax:
Practice Address - Street 1:664 SEVERS LNDG
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-6243
Practice Address - Country:US
Practice Address - Phone:727-785-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT0006345225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist