Provider Demographics
NPI:1780327833
Name:YNFIESTA RAUNO, PILAR (PTA)
Entity type:Individual
Prefix:
First Name:PILAR
Middle Name:
Last Name:YNFIESTA RAUNO
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 1:3401 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-1022
Mailing Address - Country:US
Mailing Address - Phone:239-333-5221
Mailing Address - Fax:
Practice Address - Street 1:3401 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-1022
Practice Address - Country:US
Practice Address - Phone:239-333-5221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-17
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA29634225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant