Provider Demographics
NPI:1710174909
Name:CARDONA, LINA P (PT)
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:P
Last Name:CARDONA
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 1:2499 CENTERGATE DR APT 202
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7236
Mailing Address - Country:US
Mailing Address - Phone:786-319-0599
Mailing Address - Fax:786-319-0599
Practice Address - Street 1:2499 CENTERGATE DR APT 202
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7236
Practice Address - Country:US
Practice Address - Phone:786-319-0599
Practice Address - Fax:786-319-0599
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20671225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist