Provider Demographics
NPI:1508180290
Name:REYES-MANIQUIS, LALAINE C (PT)
Entity type:Individual
Prefix:
First Name:LALAINE
Middle Name:C
Last Name:REYES-MANIQUIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LALAINE
Other - Middle Name:C
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6224 LANSDOWNE CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-5105
Mailing Address - Country:US
Mailing Address - Phone:561-732-2916
Mailing Address - Fax:
Practice Address - Street 1:6224 LANSDOWNE CIR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-5105
Practice Address - Country:US
Practice Address - Phone:561-732-2916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7322225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist