Provider Demographics
NPI:1508123035
Name:SOBERANO, ALITHEA SURBONA (PTRP, RPT)
Entity Type:Individual
Prefix:MISS
First Name:ALITHEA
Middle Name:SURBONA
Last Name:SOBERANO
Suffix:
Gender:F
Credentials:PTRP, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 SAWGRS CORP PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2859
Mailing Address - Country:US
Mailing Address - Phone:800-886-8108
Mailing Address - Fax:800-370-0755
Practice Address - Street 1:1580 SAWGRS CORP PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2859
Practice Address - Country:US
Practice Address - Phone:800-886-8108
Practice Address - Fax:800-370-0755
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-22
Last Update Date:2012-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist