Provider Demographics
NPI:1518587500
Name:ASUMBRADO, ROY (RPT)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:ASUMBRADO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5020 MYRTLE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-1766
Mailing Address - Country:US
Mailing Address - Phone:863-441-1912
Mailing Address - Fax:
Practice Address - Street 1:5020 MYRTLE BEACH DR
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-1766
Practice Address - Country:US
Practice Address - Phone:863-441-1912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT8867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist