Provider Demographics
NPI:1932226339
Name:RIVERA, LIZA MAGSINO (PT)
Entity type:Individual
Prefix:MISS
First Name:LIZA
Middle Name:MAGSINO
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 CASITA WAY APT 108
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4507
Mailing Address - Country:US
Mailing Address - Phone:561-852-4173
Mailing Address - Fax:
Practice Address - Street 1:6152 VERDE TRL N
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2430
Practice Address - Country:US
Practice Address - Phone:561-852-4173
Practice Address - Fax:561-852-4956
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 8176225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist