Provider Demographics
NPI:1376215848
Name:MEDEIROS, CLAUDIA B (PT)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:B
Last Name:MEDEIROS
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 1:806 NE 214TH LN APT 3
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-1284
Mailing Address - Country:US
Mailing Address - Phone:786-302-0683
Mailing Address - Fax:
Practice Address - Street 1:2814 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-6546
Practice Address - Country:US
Practice Address - Phone:954-441-7079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8586225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist