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General NPI Number Information
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NPI Number | 1265699284
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Entity Type | Individual
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Provider Name | MARK JUARIO P,T.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 09/16/2009
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Provider Practice Location Address
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Address Line | 3305 SW 34TH CIR SUITE 203
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City | OCALA
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State | FL
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Zip | 34474-6616
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Country | US
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Telephone | 352-351-5019
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Fax | 352-351-5236
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Provider Business Mailing Address
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Address Line | PO BOX 357279
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City | GAINESVILLE
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State | FL
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Zip | 32635-7279
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Country | US
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Telephone | 352-373-7984
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Fax | 352-332-3812
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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 | PT23756
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License Number State | FL
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