Provider Demographics
NPI:1528149192
Name:OREO, ELIZABETH A (MPT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:OREO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 SW GLENVIEW CT
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-2684
Mailing Address - Country:US
Mailing Address - Phone:772-871-6952
Mailing Address - Fax:772-871-6980
Practice Address - Street 1:814 SW GLENVIEW CT
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-2684
Practice Address - Country:US
Practice Address - Phone:772-871-6952
Practice Address - Fax:772-871-6980
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0013567225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8845ZMedicare ID - Type Unspecified