Herrera, Mibsam Lissette

Herrera, Mibsam Lissette is an sole proprietor health care provider with primary practice located at 1811 Ne 146Th St , North Miami FL 33181-1423. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Herrera, Mibsam Lissette can be contacted via phone (305) 949-4191.

Contact Information

Primary practice address
1811 Ne 146Th St North Miami FL 33181-1423
Phone: (305) 949-4191
Fax: (305) 949-4833
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X PTA1491 Florida

Profile Details

NPI number 1033306964
LBN Legal business name Herrera, Mibsam Lissette
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2007
Last updated Jul 23rd, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1033306964 NPPES
Florida Other Y902J BLUE CROSS BLUE SHIELD

Popular Providers