Individual
MR. RAYCARLOS FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2564 W 72ND PL, HIALEAH, FL 33016-6507
(786) 334-3125
Mailing address
3630 NW 19TH TER, MIAMI, FL 33125-1034
(786) 556-2163
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA31441
FL
Other
Enumeration date
09/07/2021
Last updated
10/21/2021
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