Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTAT26070 | FL |
NPI | 1013384528 |
---|---|
Provider Name | Rayko Garcia |
First Address | Gainesville, FL 32607-2249 |
Second Address | Gainesville, FL 32607-2249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2015 |
Last Update Date | 01/09/2015 |