Provider Demographics
NPI:1699042168
Name:VENTURA, ROSE CADAVOS (RPT)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:CADAVOS
Last Name:VENTURA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 ARUNDEL CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-7137
Mailing Address - Country:US
Mailing Address - Phone:239-368-9424
Mailing Address - Fax:239-368-9424
Practice Address - Street 1:712 ARUNDEL CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-7137
Practice Address - Country:US
Practice Address - Phone:239-368-9424
Practice Address - Fax:239-368-9424
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21275225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist