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General NPI Number Information
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NPI Number | 1205470838
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Entity Type | Individual
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Provider Name | PAULA M HAITO TRIBADOS ATC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 11/06/2019
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Provider Practice Location Address
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Address Line | CALLE 64 OESTE
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City | PANAMA
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State | PANAMA
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Zip | 00507
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Country | PA
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Telephone | 507-236-3483
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 NW 114TH AVE UNIT 1P
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City | MIAMI
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State | FL
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Zip | 33192-4177
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Country | US
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Telephone | 786-664-3640
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 120402006
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License Number State | FL
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