Doctor Name: | TRYSTIN ANN ENEA |
NPI Number: | 1023427366 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | PT29457 |
Business Practice Address: | 1897 Ne 146th St North Miami, FL - 331811423 |
Business Phone Number: | 3059494191 |
Business Fax Number: | |
Mailing Address: | 1250 S Miami Ave, Apt 2903 MIAMI |
State: | FL |
Postal Code: | 331304100 |
Phone Number: | 5618661935 |
Fax Number: | |
NPI Enumeration Date: | 08/12/2014 |
NPI Last Update Date: | 08/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | PT29457 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |