Provider Demographics
NPI:1528467719
Name:MURILLO, STEPHANIE (PT, DPT)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:MURILLO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 E ROUGH RIDER RD UNIT 1093
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-7352
Mailing Address - Country:US
Mailing Address - Phone:516-448-6317
Mailing Address - Fax:
Practice Address - Street 1:3935 E ROUGH RIDER RD UNIT 1093
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-7352
Practice Address - Country:US
Practice Address - Phone:516-448-6317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034166225100000X, 2251P0200X
2251P0200X
AZ31353225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics