Individual
ALLAN M FIESTA
Active
Individual
ALLAN M FIESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT009552
GA
225100000X
Physical Therapist
Primary
PT24647
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01226234
RR MEDICARE
FL
Enumeration date
07/01/2013
Last updated
02/04/2015
Update your record
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