Provider Demographics
NPI:1235155771
Name:CUNANAN, MABEL SUNIO (PT)
Entity Type:Individual
Prefix:
First Name:MABEL
Middle Name:SUNIO
Last Name:CUNANAN
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 1:20101 PEACHLAND BLVD
Mailing Address - Street 2:STE. 204
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33954-2180
Mailing Address - Country:US
Mailing Address - Phone:941-624-6491
Mailing Address - Fax:941-624-6781
Practice Address - Street 1:20101 PEACHLAND BLVD
Practice Address - Street 2:STE. 204
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954-2180
Practice Address - Country:US
Practice Address - Phone:941-624-6491
Practice Address - Fax:941-624-6781
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 9925225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist