Provider Demographics
NPI:1154694040
Name:MANALILI, ADRIAN PALOR (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:PALOR
Last Name:MANALILI
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Mailing Address - Street 1:4041 N PINE ISLAND RD
Mailing Address - Street 2:APARTMENT 404
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6520
Mailing Address - Country:US
Mailing Address - Phone:954-439-6524
Mailing Address - Fax:
Practice Address - Street 1:4041 N PINE ISLAND RD APT 404
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6520
Practice Address - Country:US
Practice Address - Phone:954-439-6524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04369225100000X
NE3164225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist