Individual
PATRICIA CUSTODIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2090 PALM BEACH LAKES BLVD STE 900, WEST PALM BEACH, FL 33409-6508
(561) 335-5965
Mailing address
105 BENT TREE DR, PALM BEACH GARDENS, FL 33418-3598
(631) 495-9999
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29763
FL
Other
Enumeration date
11/03/2019
Last updated
11/03/2019
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