Provider Demographics
NPI:1093912800
Name:CIFUENTES, MARIA V (PTA)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:V
Last Name:CIFUENTES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 LAURELHURST CT
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-5113
Mailing Address - Country:US
Mailing Address - Phone:864-879-9950
Mailing Address - Fax:347-237-1912
Practice Address - Street 1:15 LARUELHURST CT
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SD
Practice Address - Zip Code:29650
Practice Address - Country:US
Practice Address - Phone:864-879-9950
Practice Address - Fax:347-237-1912
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPTA 19962278S1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278S1500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedSNF/Subacute Care