Healthcare Provider Details

I. General information

NPI: 1750858163
Provider Name (Legal Business Name): MARGARITA FAUNI LAO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2018
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8132 HUDSON AVE
HUDSON FL
34667-8571
US

IV. Provider business mailing address

5008 BRIDGEWAY LN
LUTZ FL
33558-5700
US

V. Phone/Fax

Practice location:
  • Phone: 727-863-3100
  • Fax:
Mailing address:
  • Phone: 813-964-9226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: