Provider Demographics
NPI:1750047353
Name:FREYTIS GARAY, MARIANNA (DR)
Entity Type:Individual
Prefix:
First Name:MARIANNA
Middle Name:
Last Name:FREYTIS GARAY
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15221 SW 50TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3604
Mailing Address - Country:US
Mailing Address - Phone:305-335-1725
Mailing Address - Fax:
Practice Address - Street 1:10794 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3920
Practice Address - Country:US
Practice Address - Phone:954-735-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist