Provider Demographics
NPI:1275530875
Name:YUVIENCO, MARIA T (RPT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:T
Last Name:YUVIENCO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21301 S TAMIAMI TRL
Mailing Address - Street 2:STE 130
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-2943
Mailing Address - Country:US
Mailing Address - Phone:239-645-6295
Mailing Address - Fax:239-947-9606
Practice Address - Street 1:21301 S TAMIAMI TRL
Practice Address - Street 2:STE 130
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-2943
Practice Address - Country:US
Practice Address - Phone:239-645-6295
Practice Address - Fax:239-947-9606
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 7247225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8517AMedicare UPIN
FLK5100Medicare ID - Type UnspecifiedGROUP PROV. NUMBER