Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 18940 | FL |
NPI | 1013380732 |
---|---|
Provider Name | Raul Antonio Louzado |
First Address | Miami, FL 33165-6806 |
Second Address | Miami, FL 33165-6806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2015 |
Last Update Date | 03/11/2015 |