Provider Demographics
NPI:1568045771
Name:FLOBIL HEREDIA, CLAUDIA S (PT,DPT)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:S
Last Name:FLOBIL HEREDIA
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 ATWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-4821
Mailing Address - Country:US
Mailing Address - Phone:401-213-8799
Mailing Address - Fax:
Practice Address - Street 1:1412 ATWOOD AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-4821
Practice Address - Country:US
Practice Address - Phone:401-213-8799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047039-1225100000X
RIPT03498225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist