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General NPI Number Information
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NPI Number | 1356522411
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Entity Type | Individual
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Provider Name | MAULIKA THAKORE PT
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Gender | Female
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 11/23/2024
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Provider Practice Location Address
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Address Line | 875 WALLACE CT STE C
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City | LAKE MARY
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State | FL
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Zip | 32746-2161
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Country | US
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Telephone | 407-710-8956
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Fax | 407-732-6597
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Provider Business Mailing Address
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Address Line | 5205 PIPER LN
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City | SANFORD
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State | FL
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Zip | 32771-5465
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Country | US
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Telephone | 813-843-2401
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Fax | 407-732-6597
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 5501012430
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT30276
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License Number State | FL
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