Provider Demographics
NPI:1467630996
Name:BRITO, ROSSEANE VERAS (PT)
Entity Type:Individual
Prefix:
First Name:ROSSEANE
Middle Name:VERAS
Last Name:BRITO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22035 MARTELLA AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-4632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22035 MARTELLA AVE
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-4632
Practice Address - Country:US
Practice Address - Phone:561-245-7418
Practice Address - Fax:561-245-7418
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist