Provider Demographics
NPI:1346402005
Name:BORGES, LAURO
Entity Type:Individual
Prefix:
First Name:LAURO
Middle Name:
Last Name:BORGES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15300 S JOG RD
Mailing Address - Street 2:STE 203
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2166
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7000 W CAMINO REAL
Practice Address - Street 2:SUITE 240
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5532
Practice Address - Country:US
Practice Address - Phone:561-417-9563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT9940225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist