Provider Demographics
NPI:1134284243
Name:FIGUEROA, FERNANDO (PT, DPT, PHD)
Entity Type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:PT, DPT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 SE OSCEOLA STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2505
Mailing Address - Country:US
Mailing Address - Phone:772-223-4563
Mailing Address - Fax:772-223-4567
Practice Address - Street 1:421 SE OSCEOLA ST
Practice Address - Street 2:SUITE C
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2505
Practice Address - Country:US
Practice Address - Phone:772-223-4563
Practice Address - Fax:772-223-4567
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL69782251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650026032OtherRAILROAD MEDICARE
FLY9867ZMedicare ID - Type Unspecified