Provider Demographics
NPI:1457479651
Name:FLORENDO, MONINA (PT)
Entity Type:Individual
Prefix:MRS
First Name:MONINA
Middle Name:
Last Name:FLORENDO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MONINA
Other - Middle Name:
Other - Last Name:MAGSINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:29380 HERITAGE LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1755
Mailing Address - Country:US
Mailing Address - Phone:248-497-2943
Mailing Address - Fax:
Practice Address - Street 1:1920 OLD SPRINGVILLE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35215-5858
Practice Address - Country:US
Practice Address - Phone:205-520-0348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist