Provider Demographics
NPI:1134328552
Name:PARGUIAN, MARIPI DOLLY (PT)
Entity Type:Individual
Prefix:
First Name:MARIPI DOLLY
Middle Name:
Last Name:PARGUIAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 BROOKSHIRE CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-6666
Mailing Address - Country:US
Mailing Address - Phone:321-327-8179
Mailing Address - Fax:
Practice Address - Street 1:1091 PORT MALABAR BLVD NE
Practice Address - Street 2:SUITE 2
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-5100
Practice Address - Country:US
Practice Address - Phone:321-725-2405
Practice Address - Fax:321-725-2406
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist