MRS. Myriam Vicioso

NPI #1124240007 in Bushnell, Florida

Provider Information

NPI Number: 1124240007
Entity Type: Individual
Name: MRS. Myriam Vicioso
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Enumeration Date: May 2, 2007
Last Updated: Sep 14, 2011

Practice Location

Address: 124 S FLORIDA ST
City: Bushnell
State: Florida
ZIP Code: 33513-6704
Phone: (352) 793-8661

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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