Provider Demographics
NPI:1013490226
Name:FLORENDO, PRECILLA ANN TORRES (PT, DPT)
Entity Type:Individual
Prefix:
First Name:PRECILLA ANN
Middle Name:TORRES
Last Name:FLORENDO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 MOON SHADOW DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-4144
Mailing Address - Country:US
Mailing Address - Phone:505-386-6377
Mailing Address - Fax:
Practice Address - Street 1:PARAGON REHABILITATION
Practice Address - Street 2:2701 CHESTNUT STATION COURT
Practice Address - City:LOIUSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299
Practice Address - Country:US
Practice Address - Phone:800-335-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT4244225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist