Provider Demographics
NPI:1053159764
Name:ABRAHANTES AGUERO, ANALAY (PTA)
Entity type:Individual
Prefix:
First Name:ANALAY
Middle Name:
Last Name:ABRAHANTES AGUERO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5660 COLUMBUS RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-3417
Mailing Address - Country:US
Mailing Address - Phone:561-843-9484
Mailing Address - Fax:
Practice Address - Street 1:5660 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-3417
Practice Address - Country:US
Practice Address - Phone:561-843-9484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA31909225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty