Provider Demographics
NPI:1225056518
Name:GALICIA, HEBERTO ROY (MSPT)
Entity Type:Individual
Prefix:MR
First Name:HEBERTO
Middle Name:ROY
Last Name:GALICIA
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8558 GLENCAIRN LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1466
Mailing Address - Country:US
Mailing Address - Phone:786-417-5517
Mailing Address - Fax:305-827-4386
Practice Address - Street 1:8558 GLENCAIRN LN
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1466
Practice Address - Country:US
Practice Address - Phone:786-417-5517
Practice Address - Fax:305-827-4386
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 22298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist