Provider Demographics
NPI:1659700680
Name:HORTA, MARISOL (PT)
Entity Type:Individual
Prefix:MS
First Name:MARISOL
Middle Name:
Last Name:HORTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 SW 137TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6462
Mailing Address - Country:US
Mailing Address - Phone:305-551-3338
Mailing Address - Fax:305-551-3339
Practice Address - Street 1:3808 SW 137TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6462
Practice Address - Country:US
Practice Address - Phone:305-551-3338
Practice Address - Fax:305-551-3339
Is Sole Proprietor?:No
Enumeration Date:2013-11-12
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28818225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist