Provider Demographics
NPI:1245400175
Name:BORRAS, VIRGINIA D (PTA)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:D
Last Name:BORRAS
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 1:9610 SW 164TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3326
Mailing Address - Country:US
Mailing Address - Phone:305-234-0432
Mailing Address - Fax:
Practice Address - Street 1:9610 SW 164TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-3326
Practice Address - Country:US
Practice Address - Phone:305-234-0432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 2086225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant