Provider Demographics
NPI:1972002798
Name:CERVERA CUADROS, GIOVANNA ALEXANDRA (PT)
Entity type:Individual
Prefix:
First Name:GIOVANNA
Middle Name:ALEXANDRA
Last Name:CERVERA CUADROS
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 1:9787 OLD PATINA WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5823
Mailing Address - Country:US
Mailing Address - Phone:407-779-5217
Mailing Address - Fax:
Practice Address - Street 1:5575 S SEMORAN BLVD STE 39
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1782
Practice Address - Country:US
Practice Address - Phone:407-281-0228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT33090225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist