Basic Information
Provider Information
NPI: 1316337108
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESTINOS
FirstName: FREYA ANN
MiddleName: PAMPLIEGA
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1580 SAWGRASS CORPORATE PKWY
Address2: SUITE 100
City: SUNRISE
State: FL
PostalCode: 333232859
CountryCode: US
TelephoneNumber: 9543324445
FaxNumber: 8664226431
Practice Location
Address1: 1580 SAWGRASS CORPORATE PKWY
Address2: SUITE 100
City: SUNRISE
State: FL
PostalCode: 333232859
CountryCode: US
TelephoneNumber: 9543324445
FaxNumber: 8664226431
Other Information
ProviderEnumerationDate: 01/30/2015
LastUpdateDate: 05/31/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X31311FLN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X12956WIN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X1246431TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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