Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT19506 | FL |
Y | 2251P0200X | Physical Therapist - Pediatrics | PT19506 | FL |
NPI | 1003138421 |
---|---|
Provider Name | Charina Monton Desaulniers |
First Address | Fort Lauderdale, FL 33332-3362 |
Second Address | Fort Lauderdale, FL 33332-3362 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2010 |
Last Update Date | 26/02/2010 |