Provider Demographics
NPI:1679753743
Name:MANALO-BROSAS, SHERINE MADILANE (RPT)
Entity type:Individual
Prefix:MRS
First Name:SHERINE
Middle Name:MADILANE
Last Name:MANALO-BROSAS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11231 SNOW BELL PL
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337-6864
Mailing Address - Country:US
Mailing Address - Phone:909-429-0801
Mailing Address - Fax:
Practice Address - Street 1:11231 SNOW BELL PL
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337-6864
Practice Address - Country:US
Practice Address - Phone:909-429-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27336225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist