Provider Demographics
NPI:1992854236
Name:SYLVA, THIERRY J (PT)
Entity Type:Individual
Prefix:
First Name:THIERRY
Middle Name:J
Last Name:SYLVA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27119 MATHESON AVE
Mailing Address - Street 2:UNIT 208
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-3914
Mailing Address - Country:US
Mailing Address - Phone:786-210-0404
Mailing Address - Fax:
Practice Address - Street 1:1855 VETERANS PARK DR
Practice Address - Street 2:UNIT 101
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0446
Practice Address - Country:US
Practice Address - Phone:239-593-0918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21625225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist