Healthcare Provider Details

I. General information

NPI: 1235864224
Provider Name (Legal Business Name): MARIA VANCUYK DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA RUGGERY DPT

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 09/21/2025
Certification Date: 09/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 RICHARD JONES RD STE 210A
NASHVILLE TN
37215-2809
US

IV. Provider business mailing address

12 DUNE SIDE LN
SANTA ROSA BEACH FL
32459-5167
US

V. Phone/Fax

Practice location:
  • Phone: 615-383-0338
  • Fax: 615-383-1484
Mailing address:
  • Phone: 814-329-0887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number43759
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14127
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT43759
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: