Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA28162 | FL |
NPI | 1003311952 |
---|---|
Provider Name | Reinaldo Ramos |
First Address | Kissimmee, FL 34744-8573 |
Second Address | Oviedo, FL 32765-9262 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2018 |
Last Update Date | 23/03/2018 |