Provider Demographics
NPI:1184861288
Name:OWENS, MAURA F O'SHEA (PT)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:F O'SHEA
Last Name:OWENS
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 1:3960 N 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1808
Mailing Address - Country:US
Mailing Address - Phone:954-494-3671
Mailing Address - Fax:
Practice Address - Street 1:3960 N 39TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-1808
Practice Address - Country:US
Practice Address - Phone:954-494-3671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-11
Last Update Date:2009-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT13595225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist