Provider Demographics
NPI:1427632447
Name:WISE, PATRICIA ZORRILLA (PT, DPT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ZORRILLA
Last Name:WISE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:MERCEDES
Other - Last Name:ZORRILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:4681 AUTUMNDALE DR
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-1394
Mailing Address - Country:US
Mailing Address - Phone:561-715-4485
Mailing Address - Fax:
Practice Address - Street 1:3650 BERRYHILL RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32571-8321
Practice Address - Country:US
Practice Address - Phone:850-995-1364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT4927225100000X
FLPT42178225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist