Provider Demographics
NPI:1740933928
Name:CIMIJOTTI, SANJUANITA PRADO (PT)
Entity type:Individual
Prefix:
First Name:SANJUANITA
Middle Name:PRADO
Last Name:CIMIJOTTI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 EL CIELO LINDO CT
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-2104
Mailing Address - Country:US
Mailing Address - Phone:956-693-1285
Mailing Address - Fax:
Practice Address - Street 1:2952 BOCA CHICA BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3506
Practice Address - Country:US
Practice Address - Phone:956-243-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1287800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist