Provider Demographics
NPI:1801276886
Name:SALES, MARIA LOURDES GARCIA (PT)
Entity type:Individual
Prefix:MS
First Name:MARIA LOURDES
Middle Name:GARCIA
Last Name:SALES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 E SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6278
Mailing Address - Country:US
Mailing Address - Phone:954-234-4847
Mailing Address - Fax:
Practice Address - Street 1:1359 E SAMPLE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6278
Practice Address - Country:US
Practice Address - Phone:954-234-4847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21719225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist