Provider Demographics
NPI:1063584514
Name:FLORENDO, RHYAN FERMIN
Entity type:Individual
Prefix:
First Name:RHYAN
Middle Name:FERMIN
Last Name:FLORENDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9748 64TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2231
Mailing Address - Country:US
Mailing Address - Phone:510-367-7730
Mailing Address - Fax:
Practice Address - Street 1:9748 64TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2231
Practice Address - Country:US
Practice Address - Phone:510-367-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026675225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist