Provider Demographics
NPI:1982970794
Name:DINGAL, GENEROSA DAGOHOY (LMT)
Entity Type:Individual
Prefix:MS
First Name:GENEROSA
Middle Name:DAGOHOY
Last Name:DINGAL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E SAMPLE RD STE 3-4
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-5138
Mailing Address - Country:US
Mailing Address - Phone:561-674-5215
Mailing Address - Fax:
Practice Address - Street 1:750 E SAMPLE RD STE 3-4
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-5138
Practice Address - Country:US
Practice Address - Phone:561-674-5215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA51966172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist