Provider Demographics
NPI:1720024763
Name:LOTFI, FARIMA (PT)
Entity Type:Individual
Prefix:
First Name:FARIMA
Middle Name:
Last Name:LOTFI
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 1:12760 NW 78TH MNR
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-4524
Mailing Address - Country:US
Mailing Address - Phone:954-720-8445
Mailing Address - Fax:954-341-4076
Practice Address - Street 1:12760 NW 78TH MNR
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-4524
Practice Address - Country:US
Practice Address - Phone:954-720-8445
Practice Address - Fax:954-341-4076
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT8810225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY8974OtherBCBS
FLY8974OtherBCBS