Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1912947250 |
---|---|
Provider Name | Ms. Diane Sosa |
First Address | St Petersburg, FL 33704-3164 |
Second Address | St. Petersburg, FL 33504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 05/07/2008 |