Provider Demographics
NPI:1376841114
Name:ALBURO, ROWENA
Entity Type:Individual
Prefix:
First Name:ROWENA
Middle Name:
Last Name:ALBURO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROWENA
Other - Middle Name:MANALILI
Other - Last Name:ALBURO JR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1388 SANIBEL LN
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-7202
Mailing Address - Country:US
Mailing Address - Phone:321-482-6104
Mailing Address - Fax:
Practice Address - Street 1:1388 SANIBEL LN
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-7202
Practice Address - Country:US
Practice Address - Phone:321-482-6104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1184700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist