Provider Demographics
NPI:1962800730
Name:PINA, CESAR (PTA ,LMT)
Entity type:Individual
Prefix:MR
First Name:CESAR
Middle Name:
Last Name:PINA
Suffix:
Gender:M
Credentials:PTA ,LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3056 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2502
Mailing Address - Country:US
Mailing Address - Phone:941-706-4164
Mailing Address - Fax:941-554-8766
Practice Address - Street 1:3056 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2502
Practice Address - Country:US
Practice Address - Phone:941-706-4164
Practice Address - Fax:941-554-8766
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA30239225200000X
FLMA95767225700000X
IL160004131225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist