Provider Demographics
NPI:1013684851
Name:MAPA, PRABUDINI KUMARI (PT, DPT)
Entity Type:Individual
Prefix:
First Name:PRABUDINI
Middle Name:KUMARI
Last Name:MAPA
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 1:28808 HANGING MOSS LOOP
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-6476
Mailing Address - Country:US
Mailing Address - Phone:847-921-1592
Mailing Address - Fax:
Practice Address - Street 1:8455 W LINEBAUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-3729
Practice Address - Country:US
Practice Address - Phone:813-600-1550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-28
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34247225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist