Provider Demographics
NPI:1861943094
Name:SARAVIA CORTES, LUIS FELIPE
Entity type:Individual
Prefix:
First Name:LUIS FELIPE
Middle Name:
Last Name:SARAVIA CORTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3133 CONNECTICUT AVE NW APT 310A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5130
Mailing Address - Country:US
Mailing Address - Phone:415-314-1763
Mailing Address - Fax:
Practice Address - Street 1:3133 CONNECTICUT AVE NW APT 310A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-5130
Practice Address - Country:US
Practice Address - Phone:415-314-1763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPTA000148225200000X
CA48061225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant