Provider Demographics
NPI:1568588598
Name:GREEN-FIORILLO, RHONDA LOUISE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:LOUISE
Last Name:GREEN-FIORILLO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19735
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2434
Mailing Address - Country:US
Mailing Address - Phone:775-746-2206
Mailing Address - Fax:775-359-3332
Practice Address - Street 1:10789 DOUBLE R BLVD
Practice Address - Street 2:STE 100
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-8956
Practice Address - Country:US
Practice Address - Phone:775-746-2206
Practice Address - Fax:775-359-3332
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0848225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV36961Medicare ID - Type UnspecifiedRHONDA FIORILLO, MPT
NVP72313Medicare UPIN