Provider Demographics
NPI:1184829517
Name:OLITOQUIT, SONIA RIZZA (PTA)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:RIZZA
Last Name:OLITOQUIT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3262 ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-4220
Mailing Address - Country:US
Mailing Address - Phone:408-318-7653
Mailing Address - Fax:
Practice Address - Street 1:5901 BROKEN SOUND PKWY NW
Practice Address - Street 2:STE 500
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2773
Practice Address - Country:US
Practice Address - Phone:800-875-8999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT6072225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant