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NPI Code Detail

MEDICARE: LIANA LOSA QUINTANA PTA

MEDICARE:   LIANA  LOSA QUINTANA  PTA
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
1225200000XPhysical Therapy AssistantPTA30849FL

General Provider Information

NPI Number : 1679223135
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIANA LOSA QUINTANA PTA
Provider Business Mailing Address
First Line : 2564 W 72ND PL
Second Line :
City : HIALEAH
State : FL
Zip : 33016-6507
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2564 W 72ND PL
Second Line :
City : HIALEAH
State : FL
Zip : 33016-6507
Country : US
Telephone Number : 786-334-3125
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2022
Last Update Date : 03/28/2022

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Directions to “ LIANA LOSA QUINTANA PTA” Practice Location

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