Provider Demographics
NPI:1487300372
Name:FIGUEREDO, JOSE MANUEL
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MANUEL
Last Name:FIGUEREDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 NW 134TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-1668
Mailing Address - Country:US
Mailing Address - Phone:305-793-5510
Mailing Address - Fax:
Practice Address - Street 1:7401 MIAMI LAKES DR
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6818
Practice Address - Country:US
Practice Address - Phone:786-500-7868
Practice Address - Fax:305-512-6061
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA26314225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant