Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT8692 | FL |
NPI | 1669876694 |
---|---|
Provider Name | Mr. Rey Causin |
First Address | Parrish, FL 34219-5802 |
Second Address | Parrish, FL 34219-5802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2014 |
Last Update Date | 20/10/2014 |