Provider Demographics
NPI:1043267487
Name:TENGLIA, MARIA E (MT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:TENGLIA
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3028 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4312
Mailing Address - Country:US
Mailing Address - Phone:954-229-9222
Mailing Address - Fax:954-229-9224
Practice Address - Street 1:3028 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4312
Practice Address - Country:US
Practice Address - Phone:954-229-9222
Practice Address - Fax:954-229-9224
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA27346225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist