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General NPI Number Information
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NPI Number | 1275711798
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Entity Type | Individual
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Provider Name | MARIA ROWENA DELEON MS, LATC, ATC, PES
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Gender | Female
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 05/05/2017
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Provider Practice Location Address
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Address Line | 6150 N LOCKWOOD RIDGE RD
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City | SARASOTA
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State | FL
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Zip | 34243-2527
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Country | US
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Telephone | 941-960-4741
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Fax |
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Provider Business Mailing Address
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Address Line | 2425 BAHIA VISTA ST
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City | SARASOTA
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State | FL
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Zip | 34239-2502
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Country | US
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Telephone | 630-299-6770
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL 4430
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 096.002224
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA 27473
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License Number State | FL
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