Individual
KISHA IGLESIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
11535 CORTEZ BLVD, BROOKSVILLE, FL 34613-7373
(352) 592-0010
(352) 592-0011
Mailing address
11535 CORTEZ BLVD, BROOKSVILLE, FL 34613-7373
(352) 592-0010
(352) 592-0011
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA19025
—
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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