Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT28815 | FL |
NPI | 1063812154 |
---|---|
Provider Name | Mrs. Irene Pare Pacia-Hular |
First Address | Gainesville, FL 32608-7373 |
Second Address | Gainesville, FL 32608-7373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2014 |
Last Update Date | 26/08/2014 |