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General NPI Number Information
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NPI Number | 1114572500
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Entity Type | Individual
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Provider Name | ISHA RANABHAT PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 08/03/2019
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 3143 NE 163RD ST
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33160-4463
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Country | US
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Telephone | 130-534-3136
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Fax |
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Provider Business Mailing Address
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Address Line | 18800 NE 29TH AVE APT 924
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City | AVENTURA
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State | FL
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Zip | 33180-2853
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT33505
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT301275
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License Number State | CA
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