Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 29060 | FL |
NPI | 1013476977 |
---|---|
Provider Name | Anas Ouaffai |
First Address | Orlando, FL 32821-9387 |
Second Address | Kissimmee, FL 34746-2706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2019 |
Last Update Date | 19/03/2019 |