Provider Demographics
NPI:1255078515
Name:SUOS, GLADYS ALMOITE (PHYSICAL THERAPY)
Entity type:Individual
Prefix:MRS
First Name:GLADYS
Middle Name:ALMOITE
Last Name:SUOS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3529 E MEADOWRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-2032
Mailing Address - Country:US
Mailing Address - Phone:714-329-9105
Mailing Address - Fax:
Practice Address - Street 1:3620 LONG BEACH BLVD STE C11
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-6016
Practice Address - Country:US
Practice Address - Phone:714-329-9105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302104225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist