Provider Demographics
NPI:1235677071
Name:ISOLA, MONICA LUGO (DPT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:LUGO
Last Name:ISOLA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4098 LIBRA DR
Mailing Address - Street 2:ROOM 114
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32816-8026
Mailing Address - Country:US
Mailing Address - Phone:407-303-6610
Mailing Address - Fax:
Practice Address - Street 1:4098 LIBRA DR
Practice Address - Street 2:ROOM 114
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816-8026
Practice Address - Country:US
Practice Address - Phone:407-303-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT29815172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist