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NPI Code Detail

MEDICARE: MISS MARIA ROWENA DELEON MS, LATC, ATC, PES

MEDICARE:  MISS MARIA ROWENA DELEON  MS, LATC, ATC, PES
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
12255A2300XAthletic TrainerAL 4430FL
22255A2300XAthletic Trainer096.002224IL
3225200000XPhysical Therapy AssistantPTA 27473FL

General Provider Information

NPI Number : 1275711798
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MARIA ROWENA DELEON MS, LATC, ATC, PES
Provider Business Mailing Address
First Line : 2425 BAHIA VISTA ST
Second Line :
City : SARASOTA
State : FL
Zip : 34239-2502
Country : US
Telephone Number : 630-299-6770
Fax Number :
Provider Business Practice Location Address
First Line : 6150 N LOCKWOOD RIDGE RD
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2527
Country : US
Telephone Number : 941-960-4741
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2008
Last Update Date : 05/05/2017

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Directions to “ MISS MARIA ROWENA DELEON MS, LATC, ATC, PES” Practice Location

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