Basic Information
| Provider Information | |||||||||
| NPI: | 1487945036 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EURE | ||||||||
| FirstName: | ASTRID | ||||||||
| MiddleName: | AMPARO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 303 DELWOOD BRECK ST | ||||||||
| Address2: | |||||||||
| City: | RUSKIN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335707601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134479331 | ||||||||
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| Practice Location | |||||||||
| Address1: | 708 PEARL CIR | ||||||||
| Address2: | |||||||||
| City: | BRANDON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335104246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8133910235 | ||||||||
| FaxNumber: | 8136554818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2011 | ||||||||
| LastUpdateDate: | 04/29/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Q00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist |
No ID Information.