Provider Demographics
NPI:1740231075
Name:FREIRE, PATRICIA (PT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:FREIRE
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 1:14400 STIRLING RD
Mailing Address - Street 2:
Mailing Address - City:SW RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33330-2908
Mailing Address - Country:US
Mailing Address - Phone:786-357-1535
Mailing Address - Fax:
Practice Address - Street 1:11400 STIRLING ROAD
Practice Address - Street 2:
Practice Address - City:SW RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33330
Practice Address - Country:US
Practice Address - Phone:786-357-1535
Practice Address - Fax:305-262-4004
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT13065225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT13065OtherLICENSE