Provider Demographics
NPI:1083040323
Name:SINDA, GRAZIELLA TIDOY (PT)
Entity Type:Individual
Prefix:MRS
First Name:GRAZIELLA
Middle Name:TIDOY
Last Name:SINDA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:GRAZIELLA
Other - Middle Name:ACHAS
Other - Last Name:TIDOY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4011 NORTH PINE ISLAND ROAD
Mailing Address - Street 2:APARTMENT 404
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351
Mailing Address - Country:US
Mailing Address - Phone:954-336-2709
Mailing Address - Fax:
Practice Address - Street 1:4011 N PINE ISLAND RD
Practice Address - Street 2:APARTMENT 1- 404
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6520
Practice Address - Country:US
Practice Address - Phone:954-336-2709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist