MEDICARE: MARIAH LOMBARD

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	26888	MA
2	225100000X	Physical Therapist	FL43115	FL

General Provider Information

NPI Number	:	1821865833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAH LOMBARD

Provider Business Mailing Address
First Line	:	2727 6TH AVE S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33712-1553
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 6TH AVE S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33712-1553
Country	:	US
Telephone Number	:	727-280-6366
Fax Number	:

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

Provider Enumeration Date	:	12/08/2023
Last Update Date	:	07/08/2025

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Directions to “ MARIAH LOMBARD ” Practice Location

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