Provider Demographics
NPI:1265402101
Name:NEIMAN, JUDITH (RPT)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:
Last Name:NEIMAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 NE 203RD ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1900
Mailing Address - Country:US
Mailing Address - Phone:305-466-1388
Mailing Address - Fax:305-466-9200
Practice Address - Street 1:2627 NE 203RD ST
Practice Address - Street 2:SUITE 110
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1900
Practice Address - Country:US
Practice Address - Phone:305-466-1388
Practice Address - Fax:305-466-9200
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 6692225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL886539600Medicaid
FLX1524Medicare PIN
FLY4557XMedicare PIN