Doctor Name: | FERNANDO SOUTULLO |
NPI Number: | 1346257805 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 19318 |
Business Practice Address: | 1575 N Lake Ave Ste 205 Pasadena, CA - 911042340 |
Business Phone Number: | 6265668332 |
Business Fax Number: | |
Mailing Address: | 819 Wright Ave Apt 28, PASADENA |
State: | CA |
Postal Code: | 911044470 |
Phone Number: | 7863060778 |
Fax Number: | |
NPI Enumeration Date: | 08/01/2006 |
NPI Last Update Date: | 01/21/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 19318 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |