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NPI Code Detail

MEDICARE: LUISA BALINGIT CORTEZ P.T.

MEDICARE: LUISA BALINGIT CORTEZ P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist070019766IL
2225100000XPhysical TherapistPT29100FL

General Provider Information

NPI Number : 1417373630
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUISA BALINGIT CORTEZ P.T.
Provider Business Mailing Address
First Line : 700 S 29TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-3626
Country : US
Telephone Number : 772-252-4618
Fax Number :
Provider Business Practice Location Address
First Line : 700 S 29TH ST
Second Line :
City : FORT PIERCE
State : FL
Zip : 34947-3626
Country : US
Telephone Number : 772-252-4618
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2014
Last Update Date : 10/22/2015

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