Provider Demographics
NPI:1053459370
Name:BITTAR, MARIA B (PT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:B
Last Name:BITTAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:B
Other - Last Name:BITTAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:7600 W 20TH AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1895
Mailing Address - Country:US
Mailing Address - Phone:305-822-8815
Mailing Address - Fax:305-822-8873
Practice Address - Street 1:2140 W 68TH ST
Practice Address - Street 2:STE 101
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1815
Practice Address - Country:US
Practice Address - Phone:305-822-8815
Practice Address - Fax:305-822-8873
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7837225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY4291AOtherMEDICARE LEGACY
FLY4291AOtherMEDICARE LEGACY