Provider Demographics
NPI:1407850092
Name:APONTE, MARIELA (PT)
Entity type:Individual
Prefix:MRS
First Name:MARIELA
Middle Name:
Last Name:APONTE
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 1:601 NW 106TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3960
Mailing Address - Country:US
Mailing Address - Phone:954-441-0310
Mailing Address - Fax:954-436-1648
Practice Address - Street 1:601 NW 106TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3960
Practice Address - Country:US
Practice Address - Phone:954-441-0310
Practice Address - Fax:954-436-1648
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT11757225100000X
FLMT27143225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY7716AMedicare ID - Type UnspecifiedMEDICARE PART B PROVIDER