Provider Demographics
NPI:1962527135
Name:REYES, APRIL BOLTIADOR (RPT)
Entity type:Individual
Prefix:MISS
First Name:APRIL
Middle Name:BOLTIADOR
Last Name:REYES
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 BROOKSHIRE CIR
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-6666
Mailing Address - Country:US
Mailing Address - Phone:321-704-6625
Mailing Address - Fax:
Practice Address - Street 1:7201 GREENBORO DR
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-1698
Practice Address - Country:US
Practice Address - Phone:321-727-0990
Practice Address - Fax:321-724-5289
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23123225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist