Healthcare Provider Details

I. General information

NPI: 1437081924
Provider Name (Legal Business Name): VIVIANE MARIANI TICIANELLI PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19801 HAMPTON DR STE C3C4
BOCA RATON FL
33434-2840
US

IV. Provider business mailing address

19801 HAMPTON DR STE C3C4
BOCA RATON FL
33434-2840
US

V. Phone/Fax

Practice location:
  • Phone: 954-554-7531
  • Fax:
Mailing address:
  • Phone: 954-554-7531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT44735
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: