Healthcare Provider Details

I. General information

NPI: 1619086600
Provider Name (Legal Business Name): LUCIA MARGARITA DEL RIO P.T.A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW 16TH ST
MIAMI FL
33125-1624
US

IV. Provider business mailing address

6310 NW 38TH TER
VIRGINIA GARDENS FL
33166-7035
US

V. Phone/Fax

Practice location:
  • Phone: 305-575-7000
  • Fax:
Mailing address:
  • Phone: 305-870-0738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA13219
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: