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General NPI Number Information
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NPI Number | 1164637765
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Entity Type | Individual
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Provider Name | DOROTHY ANNE YBANEZ-LUEL RPT
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3591 W WOOLBRIGHT RD
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-7243
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Country | US
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Telephone | 561-742-3345
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Fax | 561-742-8933
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Provider Business Mailing Address
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Address Line | 4019 CRESCENT CREEK CT
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City | COCONUT CREEK
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State | FL
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Zip | 33073-3113
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Country | US
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Telephone | 561-742-3345
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Fax | 561-742-8933
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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 | PT10430
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License Number State | FL
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