Provider Demographics
NPI:1952809337
Name:GARCIA-PRIETO, ANTHONY (PTA24772)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:GARCIA-PRIETO
Suffix:
Gender:M
Credentials:PTA24772
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3898 WEST FLAGLER STREET
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:786-409-3203
Mailing Address - Fax:
Practice Address - Street 1:3898 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1614
Practice Address - Country:US
Practice Address - Phone:786-409-3203
Practice Address - Fax:786-615-3811
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA24772225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant