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Individual

MISS GAITRI PERSAUD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1191 E NEWPORT CENTER DR, PENT HOUSE J, DEERFIELD BEACH, FL 33442-7715
(954) 379-1066
Mailing address
403 NW 68TH AVE, #505, PLANTATION, FL 33317-7585
(954) 918-5344

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
PTA20424
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTA20424
PHYSICAL THERAPY ASSISTAN
FL
Enumeration date
05/22/2007
Last updated
07/08/2007
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