MEDICARE: MARY ANNE DICARO PT

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
1	225100000X	Physical Therapist	3518	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285765305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ANNE DICARO PT

Provider Business Mailing Address
First Line	:	7122 W SOFTWIND DR
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383-3247
Country	:	US
Telephone Number	:	602-762-5272
Fax Number	:

Provider Business Practice Location Address
First Line	:	14300 W GRANITE VALLEY DR STE E21
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-5798
Country	:	US
Telephone Number	:	623-546-6712
Fax Number	:	623-546-6739

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	02/23/2022

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Directions to “ MARY ANNE DICARO PT” Practice Location

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