Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT2843 | FL |
N | 2251G0304X | Physical Therapist - Geriatrics | PT2843 | FL |
Y | 2251N0400X | Physical Therapist - Neurology | PT2843 | FL |
N | 2251X0800X | Physical Therapist - Orthopedic | PT2843 | FL |
NPI | 1699780189 |
---|---|
Provider Name | Mrs. Fulvia Vlieg Barrera |
First Address | Miami, FL 33176-2306 |
Second Address | Miami, FL 33176-2306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 10/10/2011 |