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Individual

MR. JOHN G. RAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CCC-A

Contact information

Practice address
1717 S ORANGE AVE, SUITE 100, ORLANDO, FL 32806-2944
(407) 650-7000
(407) 650-7124
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY1068
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
600320600
FL
Enumeration date
08/29/2006
Last updated
09/16/2011
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