Healthcare Provider Details

I. General information

NPI: 1023444304
Provider Name (Legal Business Name): RUTH LORINE COSCHIGNANO L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3461 EDGEWATER DR
ORLANDO FL
32804-3601
US

IV. Provider business mailing address

3461 EDGEWATER DR
ORLANDO FL
32804-3601
US

V. Phone/Fax

Practice location:
  • Phone: 407-250-6749
  • Fax: 407-250-6749
Mailing address:
  • Phone: 407-250-6749
  • Fax: 407-250-6749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA73246
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: