Provider Demographics
NPI:1457471955
Name:SOBERANES, CLAUDIO (PT)
Entity Type:Individual
Prefix:
First Name:CLAUDIO
Middle Name:
Last Name:SOBERANES
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 1:4730 SW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4518
Mailing Address - Country:US
Mailing Address - Phone:786-362-5482
Mailing Address - Fax:305-397-2846
Practice Address - Street 1:4730 SW 72ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4518
Practice Address - Country:US
Practice Address - Phone:786-362-5482
Practice Address - Fax:305-397-2846
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT16139225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3343XOtherMEDICARE
FLE3343ZMedicare PIN
FLE3343Medicare PIN