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NPI Code Detail

MEDICARE: GLORIA VASOLO PT

MEDICARE: GLORIA VASOLO PT
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 TherapistPT10348FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AD868YOTHERFLLEGACY

General Provider Information

NPI Number : 1871505446
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLORIA VASOLO PT
Provider Business Mailing Address
First Line : 17100 COLLINS AVE
Second Line :
City : SUNNY ISLES BEACH
State : FL
Zip : 33160-3675
Country : US
Telephone Number : 305-555-1212
Fax Number :
Provider Business Practice Location Address
First Line : 17100 COLLINS AVE
Second Line :
City : SUNNY ISLES BEACH
State : FL
Zip : 33160-3675
Country : US
Telephone Number : 305-555-1212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2006
Last Update Date : 03/12/2015

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Directions to “ GLORIA VASOLO PT” Practice Location

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