Healthcare Provider Details

I. General information

NPI: 1447092820
Provider Name (Legal Business Name): LILY PINTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 W PALMETTO PARK RD STE 202
BOCA RATON FL
33432-3760
US

IV. Provider business mailing address

9653 OREGON RD
BOCA RATON FL
33434-2309
US

V. Phone/Fax

Practice location:
  • Phone: 561-494-4499
  • Fax: 561-705-7501
Mailing address:
  • Phone: 561-674-6206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA33184
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: