Provider Demographics
NPI:1760867816
Name:ROBERTSON, MONICA TUZZOLOBURNS (PT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:TUZZOLOBURNS
Last Name:ROBERTSON
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 1:2451 BRICKELL AVE
Mailing Address - Street 2:15-B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2436
Mailing Address - Country:US
Mailing Address - Phone:305-409-4843
Mailing Address - Fax:
Practice Address - Street 1:1500 SAN REMO AVE STE 170
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3054
Practice Address - Country:US
Practice Address - Phone:305-779-2427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 30609225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist