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General NPI Number Information
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NPI Number | 1225146822
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Entity Type | Individual
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Provider Name | MARIA FORNOLES
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Gender | Female
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 706 E GRAND HWY
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City | CLERMONT
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State | FL
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Zip | 34711-3708
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Country | US
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Telephone | 352-242-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 600 RIVER BIRCH CT APT 336
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City | CLERMONT
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State | FL
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Zip | 34711-5146
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Country | US
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Telephone | 407-617-7621
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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