Provider Demographics
NPI:1881998839
Name:BORES, PATRICIA (MSPT)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:BORES
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 S COLLIER BLVD
Mailing Address - Street 2:UNIT 105
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-4829
Mailing Address - Country:US
Mailing Address - Phone:239-642-3948
Mailing Address - Fax:239-642-4243
Practice Address - Street 1:291 S COLLIER BLVD
Practice Address - Street 2:UNIT 105
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-4829
Practice Address - Country:US
Practice Address - Phone:239-642-3948
Practice Address - Fax:239-642-4243
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20480225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist