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1770117202
RIVAZZELLY BASTARDO
HIALEAH, FL
NPI
1770117202
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: FL Pta30057)
Enumeration Date
2020-02-24
Last Update Date
2020-02-24
Business Address
RIVAZZELLY BASTARDO PTA
900 W 49TH ST STE 332
HIALEAH, FL 33012-3489
Phone number: 786-879-5303
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Mailing Address
RIVAZZELLY BASTARDO PTA
18965 NW 62ND AVE APT 212
HIALEAH, FL 33015-5057
Phone number: 786-901-0053
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