Provider Demographics
NPI:1801086517
Name:ARONG, GLENDA (RPT)
Entity type:Individual
Prefix:
First Name:GLENDA
Middle Name:
Last Name:ARONG
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:GLENDA
Other - Middle Name:ARONG
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPT
Mailing Address - Street 1:6137 LANSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-3042
Mailing Address - Country:US
Mailing Address - Phone:813-886-8861
Mailing Address - Fax:
Practice Address - Street 1:6137 LANSHIRE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-3042
Practice Address - Country:US
Practice Address - Phone:813-368-0242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-29
Last Update Date:2007-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT12592225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist