MEDICARE: DAYMARA NODARSE 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
1	225200000X	Physical Therapy Assistant	PTA27635	FL

General Provider Information

NPI Number	:	1831838150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAYMARA NODARSE PTA

Provider Business Mailing Address
First Line	:	7336 W 18TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-3711
Country	:	US
Telephone Number	:	786-683-8022
Fax Number	:

Provider Business Practice Location Address
First Line	:	7336 W 18TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-3711
Country	:	US
Telephone Number	:	786-683-8022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2022
Last Update Date	:	06/03/2022

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Directions to “ DAYMARA NODARSE PTA” Practice Location

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