Individual
MR. RUDEL NATIVIDAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1465 OAKFIELD DR, BRANDON, FL 33511-4854
(813) 685-3970
Mailing address
10125 CANNON DR, RIVERVIEW, FL 33578-8339
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT20567
FL
Other
Enumeration date
01/30/2012
Last updated
01/30/2012
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