Provider Demographics
NPI:1245855451
Name:DA ROCHA, NAINE SILVA
Entity type:Individual
Prefix:
First Name:NAINE
Middle Name:SILVA
Last Name:DA ROCHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 S CONGRESS AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7667
Mailing Address - Country:US
Mailing Address - Phone:561-408-0903
Mailing Address - Fax:
Practice Address - Street 1:2324 CONGRESS AVE.
Practice Address - Street 2:SUITE 1A
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-3340
Practice Address - Country:US
Practice Address - Phone:561-408-0903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA30189225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty