Provider Demographics
NPI:1437485869
Name:RUFFOLO, BRIGITTE ESTELA (PTA)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:ESTELA
Last Name:RUFFOLO
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 1:10410 SW 153RD CT
Mailing Address - Street 2:APT #5
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2712
Mailing Address - Country:US
Mailing Address - Phone:305-305-8987
Mailing Address - Fax:305-228-6251
Practice Address - Street 1:10410 SW 153RD CT
Practice Address - Street 2:APT #5
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-2712
Practice Address - Country:US
Practice Address - Phone:305-305-8987
Practice Address - Fax:305-228-6251
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA20779225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant