Provider Demographics
NPI:1235130055
Name:LONTOC, MARIA LILIBETH (PT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LILIBETH
Last Name:LONTOC
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 1:1900 HIGHLAND OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-7323
Mailing Address - Country:US
Mailing Address - Phone:813-949-0003
Mailing Address - Fax:813-994-0302
Practice Address - Street 1:1900 HIGHLAND OAKS BLVD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-7323
Practice Address - Country:US
Practice Address - Phone:813-949-0003
Practice Address - Fax:813-994-0302
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5895225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist