Provider Demographics
NPI:1871244681
Name:SARAGUSTI, BIANCA (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:BIANCA
Middle Name:
Last Name:SARAGUSTI
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13164 NW 18TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2500
Mailing Address - Country:US
Mailing Address - Phone:954-260-4157
Mailing Address - Fax:
Practice Address - Street 1:635 CENTURY PT STE 111
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2139
Practice Address - Country:US
Practice Address - Phone:407-792-0031
Practice Address - Fax:407-255-2016
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT38224225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist