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NPI Code Detail

MEDICARE: MS. SONIA IVETTE CUBERO P.T.

MEDICARE:  MS. SONIA IVETTE CUBERO  P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251G0304XGeriatric Physical Therapist5394NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15394OTHERNCPHYSICAL THERAPY LICENSE

General Provider Information

NPI Number : 1023186343
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SONIA IVETTE CUBERO P.T.
Provider Business Mailing Address
First Line : 130 STONE HAVEN CT
Second Line :
City : SALISBURY
State : NC
Zip : 28146-3235
Country : US
Telephone Number : 704-279-7940
Fax Number :
Provider Business Practice Location Address
First Line : 1810 CONCORD LAKE RD
Second Line :
City : KANNAPOLIS
State : NC
Zip : 28083-6434
Country : US
Telephone Number : 704-933-3781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2006
Last Update Date : 07/08/2007

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