Provider Demographics
NPI:1356525380
Name:SURIN, YVES MICHEL (PHYSICAL THERAPIST A)
Entity type:Individual
Prefix:MR
First Name:YVES
Middle Name:MICHEL
Last Name:SURIN
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 CAVAN DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-8344
Mailing Address - Country:US
Mailing Address - Phone:407-967-1056
Mailing Address - Fax:
Practice Address - Street 1:899 CAVAN DR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-8344
Practice Address - Country:US
Practice Address - Phone:407-967-1056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003861-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant