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NPI 1366230724

NPI 1366230724 : SHIVIKA SUNIL MASKARA : LUTZ, FL

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General NPI Number Information
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    NPI Number           |    1366230724
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    Entity Type          |    Individual 
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    Provider Name        |    SHIVIKA SUNIL MASKARA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/28/2025
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    Last Update Date     |    04/28/2025
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Provider Practice Location Address
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    Address Line         |    3840 ATMORE GROVE DR 
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    City                 |    LUTZ
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    State                |    FL
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    Zip                  |    33548-7903
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    Country              |    US
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    Telephone            |    412-961-2005
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3138 DUNSTABLE DR 
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    City                 |    LAND O LAKES
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    State                |    FL
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    Zip                  |    34638-7949
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    Country              |    US
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    Telephone            |    412-961-2005
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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        |    2251G0304X
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    Taxonomy Name        |    Geriatric Physical Therapist
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    License Number       |    PT33822
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    License Number State |    FL
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