Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA27702 | FL |
NPI | 1013405455 |
---|---|
Provider Name | Urvi Mehta |
First Address | Pembroke Pines, FL 33029-3832 |
Second Address | Weston, FL 33331-3651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2018 |
Last Update Date | 30/04/2018 |