Provider Demographics
NPI:1518017110
Name:SHAFIEE, FLORA MOHAMED F (DPTS)
Entity Type:Individual
Prefix:MRS
First Name:FLORA
Middle Name:MOHAMED F
Last Name:SHAFIEE
Suffix:
Gender:F
Credentials:DPTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 W FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-4700
Mailing Address - Country:US
Mailing Address - Phone:909-874-5444
Mailing Address - Fax:909-874-5445
Practice Address - Street 1:851 W FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-4700
Practice Address - Country:US
Practice Address - Phone:909-874-5444
Practice Address - Fax:909-874-5445
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT17474225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist