Provider Demographics
NPI:1699142976
Name:BALDONADO, ROSALITA
Entity type:Individual
Prefix:
First Name:ROSALITA
Middle Name:
Last Name:BALDONADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:BALDONADO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:8250 SW 72ND CT
Mailing Address - Street 2:SUITE 135
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4215
Mailing Address - Country:US
Mailing Address - Phone:973-898-0233
Mailing Address - Fax:
Practice Address - Street 1:8250 SW 72ND CT
Practice Address - Street 2:SUITE 135
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4215
Practice Address - Country:US
Practice Address - Phone:973-898-0233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT29070225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist