Provider Demographics
NPI:1447313101
Name:MIRANDA-ADLER, M. T. VERONICA REYES (PT)
Entity type:Individual
Prefix:
First Name:M. T. VERONICA
Middle Name:REYES
Last Name:MIRANDA-ADLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA TERESA VERONIC
Other - Middle Name:REYES
Other - Last Name:MIRANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:9744 SW 123RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-4934
Mailing Address - Country:US
Mailing Address - Phone:305-255-5343
Mailing Address - Fax:305-255-5343
Practice Address - Street 1:9744 SW 123RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-4934
Practice Address - Country:US
Practice Address - Phone:305-255-5343
Practice Address - Fax:305-255-5343
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist