Provider Demographics
NPI:1588977565
Name:MIGLIANO, CATHERINEMARY BERNADETTE (PTA)
Entity type:Individual
Prefix:
First Name:CATHERINEMARY
Middle Name:BERNADETTE
Last Name:MIGLIANO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 N UNIVERSITY DR
Mailing Address - Street 2:STE 102-127
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4115
Mailing Address - Country:US
Mailing Address - Phone:954-614-0623
Mailing Address - Fax:267-336-0220
Practice Address - Street 1:1802 N UNIVERSITY DR
Practice Address - Street 2:STE 102-127
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-4115
Practice Address - Country:US
Practice Address - Phone:954-614-0623
Practice Address - Fax:267-336-0220
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
FLPTA22020225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No174400000XOther Service ProvidersSpecialist