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NPI Code Detail

MEDICARE: MRS. DREAMA MARIE WALDROP P.T.

MEDICARE: MRS. DREAMA MARIE WALDROP P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT5855FL

General Provider Information

NPI Number : 1275538712
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DREAMA MARIE WALDROP P.T.
Provider Business Mailing Address
First Line : 8455 S SUNCOAST BLVD
Second Line :
City : HOMOSASSA
State : FL
Zip : 34446-5066
Country : US
Telephone Number : 352-564-7010
Fax Number : 352-382-4297
Provider Business Practice Location Address
First Line : 8455 S SUNCOAST BLVD
Second Line :
City : HOMOSASSA
State : FL
Zip : 34446-5066
Country : US
Telephone Number : 352-564-7010
Fax Number : 352-382-4297
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 07/08/2007

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