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General NPI Number Information
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NPI Number | 1770131872
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Entity Type | Individual
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Provider Name | MARIA DULCE GARDUQUE
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Gender | Female
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Dates
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Enumeration Date | 09/01/2019
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Last Update Date | 09/01/2019
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Provider Practice Location Address
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Address Line | 830 29TH ST
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City | ORLANDO
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State | FL
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Zip | 32805-6219
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Country | US
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Telephone | 407-843-2330
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Fax |
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Provider Business Mailing Address
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Address Line | 83 GENEVA DR # 622086
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City | OVIEDO
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State | FL
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Zip | 32765-6777
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Country | US
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Telephone | 201-706-0699
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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 | PT34709
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License Number State | FL
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