1588977565 NPI number — CATHERINEMARY BERNADETTE MIGLIANO PTA

Table of content: CATHERINEMARY BERNADETTE MIGLIANO PTA (NPI 1588977565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588977565 NPI number — CATHERINEMARY BERNADETTE MIGLIANO PTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MIGLIANO
Provider First Name:
CATHERINEMARY
Provider Middle Name:
BERNADETTE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PTA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588977565
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1802 N UNIVERSITY DR
Provider Second Line Business Mailing Address:
STE 102-127
Provider Business Mailing Address City Name:
PLANTATION
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33322-4115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-614-0623
Provider Business Mailing Address Fax Number:
267-336-0220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1802 N UNIVERSITY DR
Provider Second Line Business Practice Location Address:
STE 102-127
Provider Business Practice Location Address City Name:
PLANTATION
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33322-4115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-614-0623
Provider Business Practice Location Address Fax Number:
267-336-0220
Provider Enumeration Date:
07/20/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225200000X , with the licence number: PTA22020 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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