Individual
MIRIAM COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
735 BRIARGROVE AVE, DAVENPORT, FL 33837-5841
(863) 221-8858
Mailing address
735 BRIARGROVE AVE, DAVENPORT, FL 33837-5841
(863) 221-8858
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1853
FL
Other
Enumeration date
05/22/2007
Last updated
01/09/2009
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