Basic Information
Provider Information
NPI: 1023183852
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GAY
FirstName: RHONDA
MiddleName: LORRAINE
NamePrefix: MS.
NameSuffix:  
Credential: PHYSICAL THERAPIST
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2252 WAYCROSS ROAD
Address2:  
City: CINCINNATI
State: OH
PostalCode: 45240
CountryCode: US
TelephoneNumber: 5137422333
FaxNumber: 5137420943
Practice Location
Address1: 950 GLADES ROAD
Address2: SUITE 200
City: BOCA RATON
State: FL
PostalCode: 33431
CountryCode: US
TelephoneNumber: 5618260334
FaxNumber: 5618260376
Other Information
ProviderEnumerationDate: 11/20/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT21091FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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