Provider Demographics
NPI:1073857348
Name:PETIONNAIS, FIFINE (RESPIRATORY THERAPY)
Entity Type:Individual
Prefix:MS
First Name:FIFINE
Middle Name:
Last Name:PETIONNAIS
Suffix:
Gender:F
Credentials:RESPIRATORY THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1198 NE 159TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-5404
Mailing Address - Country:US
Mailing Address - Phone:786-294-1892
Mailing Address - Fax:
Practice Address - Street 1:1198 NE 159TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-5404
Practice Address - Country:US
Practice Address - Phone:786-294-1892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT14572227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified