Provider Demographics
NPI:1699946293
Name:LATINO-FELIZ, ARACELLY ROSARIO (PT)
Entity type:Individual
Prefix:MS
First Name:ARACELLY
Middle Name:ROSARIO
Last Name:LATINO-FELIZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:ARACELLY
Other - Middle Name:
Other - Last Name:LATINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:10368 W STATE ROAD 84 STE 104
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4242
Mailing Address - Country:US
Mailing Address - Phone:954-591-4278
Mailing Address - Fax:
Practice Address - Street 1:10368 W STATE ROAD 84 STE 104
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-4242
Practice Address - Country:US
Practice Address - Phone:954-591-4278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36870225100000X
FLPT23903225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist