Organization
RAYPAR INC
Active
Other names
Pediatric Partners of WH
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY A STANWOOD (ADMINISTRATOR)
(863) 401-8516
Entity
Organization
Contact information
Practice address
550 POPE AVE NW, SUITE 100, WINTER HAVEN, FL 33881-4679
(863) 293-2144
(863) 293-3732
Mailing address
550 POPE AVE NW, SUITE 100, WINTER HAVEN, FL 33881-4679
(863) 293-2144
(863) 293-3732
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0069091
FL
208000000X
Pediatrics Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002983100
—
FL
05
—
660185500
—
FL
Enumeration date
09/29/2006
Last updated
07/15/2014
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