Healthcare Provider Details

I. General information

NPI: 1780266528
Provider Name (Legal Business Name): CLAIRE LOVE WILSON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 SW 37TH AVE STE 906
CORAL GABLES FL
33133-2751
US

IV. Provider business mailing address

2601 SW 37TH AVE STE 906
CORAL GABLES FL
33133-2751
US

V. Phone/Fax

Practice location:
  • Phone: 803-807-0733
  • Fax:
Mailing address:
  • Phone: 803-807-0733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number300108
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305215496
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT44146
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1408066
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: