Provider Demographics
NPI:1356667000
Name:LALLA, PARBATEE R (PTA)
Entity Type:Individual
Prefix:MS
First Name:PARBATEE
Middle Name:R
Last Name:LALLA
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 1:8051 SW 159TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3062
Mailing Address - Country:US
Mailing Address - Phone:305-338-0684
Mailing Address - Fax:
Practice Address - Street 1:756 W PALM DR
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-3224
Practice Address - Country:US
Practice Address - Phone:305-246-3530
Practice Address - Fax:305-246-4585
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 13199225200000X
FLMA 29368225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist