Provider Demographics
NPI:1225072085
Name:GITLIN, YEVGENIA J (PT)
Entity Type:Individual
Prefix:
First Name:YEVGENIA
Middle Name:J
Last Name:GITLIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3428 N ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4224
Mailing Address - Country:US
Mailing Address - Phone:305-295-9797
Mailing Address - Fax:305-295-9796
Practice Address - Street 1:3428 N ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4224
Practice Address - Country:US
Practice Address - Phone:305-295-9797
Practice Address - Fax:305-295-9796
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT12965225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0192ZMedicare ID - Type UnspecifiedINDIVIDUAL
FL38363Medicare ID - Type UnspecifiedGROUP NUMBER