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Individual

MS. BIRLYNN OCTAVA STA.CLARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
3201 W COMMERCIAL BLVD, SUITE 116, FORT LAUDERDALE, FL 33309-3440
(954) 739-4247
Mailing address
3290 N RIDGE RD, SUITE 290, ELLICOTT CITY, MD 21043-3655
(410) 750-9006

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
NJ

Other

Enumeration date
11/08/2007
Last updated
11/08/2007
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