Provider Demographics
NPI:1104931484
Name:GARLAND PADRINO, GAIL RUTH (PTA)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:RUTH
Last Name:GARLAND PADRINO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4511 S OCEAN BLVD
Mailing Address - Street 2:#1002
Mailing Address - City:HIGHLAND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33487-4276
Mailing Address - Country:US
Mailing Address - Phone:561-278-8874
Mailing Address - Fax:
Practice Address - Street 1:1786 NW BOCA RATON BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1616
Practice Address - Country:US
Practice Address - Phone:561-368-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 014090225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant