Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT33061 | FL |
N | 2251C2600X | Cardiopulmonary | PT33061 | FL |
N | 2251X0800X | Physical Therapist - Orthopedic | PT33601 | FL |
NPI | 1134630353 |
---|---|
Provider Name | Mansi Mandaliya |
First Address | Tampa, FL 33647-3646 |
Second Address | Tampa, FL 33647-3646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2017 |
Last Update Date | 15/10/2017 |