Provider Demographics
NPI:1407212244
Name:SORIANO, RAMIR BAUTISTA (PT)
Entity Type:Individual
Prefix:
First Name:RAMIR
Middle Name:BAUTISTA
Last Name:SORIANO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5634 HILLVIEW CT
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810-3246
Mailing Address - Country:US
Mailing Address - Phone:863-513-9058
Mailing Address - Fax:863-583-0390
Practice Address - Street 1:5634 HILLVIEW CT
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33810-3246
Practice Address - Country:US
Practice Address - Phone:863-513-9058
Practice Address - Fax:863-583-0390
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-09
Last Update Date:2016-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15502225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist