Provider Demographics
NPI:1164637765
Name:YBANEZ-LUEL, DOROTHY ANNE (RPT)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:ANNE
Last Name:YBANEZ-LUEL
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4019 CRESCENT CREEK CT
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3113
Mailing Address - Country:US
Mailing Address - Phone:561-742-3345
Mailing Address - Fax:561-742-8933
Practice Address - Street 1:3591 W WOOLBRIGHT RD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-7243
Practice Address - Country:US
Practice Address - Phone:561-742-3345
Practice Address - Fax:561-742-8933
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT10430225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7292ZMedicare ID - Type Unspecified