Provider Demographics
NPI:1013674969
Name:CHUA, FLORENTINA JOY (PT)
Entity Type:Individual
Prefix:
First Name:FLORENTINA
Middle Name:JOY
Last Name:CHUA
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 1:5189 WEXFORD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-6708
Mailing Address - Country:US
Mailing Address - Phone:321-960-5765
Mailing Address - Fax:
Practice Address - Street 1:777 ROY WALL BLVD
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-6217
Practice Address - Country:US
Practice Address - Phone:321-872-8010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT12662225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist