Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT4215 | FL |
N | 2251N0400X | Physical Therapist - Neurology | PT 4215 | FL |
NPI | 1336387976 |
---|---|
Provider Name | Ms. Judy Farace |
First Address | Naples, FL 34114-9611 |
Second Address | Naples, FL 34114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2009 |
Last Update Date | 25/04/2019 |