Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT773 | FL |
NPI | 1003002056 |
---|---|
Provider Name | May Ouano |
First Address | Hudson, FL 34669-2572 |
Second Address | Bayonet Point, FL 34667-6789 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2007 |
Last Update Date | 19/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PT773 | STATE LICENSE (01) | FL |