Healthcare Provider Details

I. General information

NPI: 1598519183
Provider Name (Legal Business Name): LUCIANA MONDINI SILVA MUNIZ PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3994 W HILLSBORO BLVD
DEERFIELD BEACH FL
33442-9416
US

IV. Provider business mailing address

6958 PALMETTO CIR S APT 402
BOCA RATON FL
33433-3525
US

V. Phone/Fax

Practice location:
  • Phone: 954-360-7779
  • Fax:
Mailing address:
  • Phone: 561-341-9058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number36963
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: