Provider Demographics
NPI:1316279110
Name:SHIMODA, YOKO (PT)
Entity type:Individual
Prefix:MS
First Name:YOKO
Middle Name:
Last Name:SHIMODA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 SE TOWER DR
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7615
Mailing Address - Country:US
Mailing Address - Phone:772-286-7895
Mailing Address - Fax:
Practice Address - Street 1:6011 SE TOWER DR
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-7615
Practice Address - Country:US
Practice Address - Phone:772-286-7895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist