Provider Demographics
NPI:1275711798
Name:DELEON, MARIA ROWENA (MS, LATC, ATC, PES)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ROWENA
Last Name:DELEON
Suffix:
Gender:F
Credentials:MS, LATC, ATC, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 BAHIA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2502
Mailing Address - Country:US
Mailing Address - Phone:630-299-6770
Mailing Address - Fax:
Practice Address - Street 1:6150 N LOCKWOOD RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2527
Practice Address - Country:US
Practice Address - Phone:941-960-4741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 44302255A2300X
IL096.0022242255A2300X
FLPTA 27473225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer