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General NPI Number Information
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NPI Number | 1346434008
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Entity Type | Individual
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Provider Name | LLOYD SATO BAYNOSA PHYSICAL THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 09/05/2007
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | MEDPRO STAFFING 3201 W COMMERCIAL BLVD, SUITE 116
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City | FT. LAUDERDALE
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State | FL
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Zip | 33309
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Country | US
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Telephone | 866-608-2670
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Fax |
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Provider Business Mailing Address
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Address Line | 31 VINE ST APT 37
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City | WEYMOUTH
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State | MA
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Zip | 02188-2319
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Country | US
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Telephone | 781-277-1174
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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 | 17789
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License Number State | MA
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