MEDICARE: MISLEYDIS B GREGORES

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
1	225200000X	Physical Therapy Assistant	PTA32686	FL

General Provider Information

NPI Number	:	1861344202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISLEYDIS B GREGORES

Provider Business Mailing Address
First Line	:	3340 NW 177TH TER
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-3953
Country	:	US
Telephone Number	:	305-397-4565
Fax Number	:

Provider Business Practice Location Address
First Line	:	3340 NW 177TH TER
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-3953
Country	:	US
Telephone Number	:	305-397-4565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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Directions to “ MISLEYDIS B GREGORES ” Practice Location

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