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General NPI Number Information
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NPI Number | 1932928298
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Entity Type | Individual
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Provider Name | NINO MARK UY PT
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Gender | Male
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Dates
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Enumeration Date | 10/04/2024
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 4745 FOUR LAKES CIR SW FL 32960
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City | VERO BEACH
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State | FL
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Zip | 32968-4802
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Country | US
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Telephone | 863-634-3023
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Fax |
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Provider Business Mailing Address
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Address Line | 8167 NW GREENBANK CIR
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City | PORT ST LUCIE
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State | FL
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Zip | 34987-3044
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Country | US
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Telephone | 777-666-1116
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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 | PT32962
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License Number State | FL
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