Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT22572 | FL |
NPI | 1003186131 |
---|---|
Provider Name | Miss Germela Oliveros Valdriz |
First Address | Kissimmee, FL 34741-3762 |
Second Address | Kissimmee, FL 34741-2247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2012 |
Last Update Date | 05/01/2012 |