Provider Demographics
NPI:1669638250
Name:ESTIPONA, MARIA CECILIA POSADA (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARIA CECILIA
Middle Name:POSADA
Last Name:ESTIPONA
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 1:3949 HERONS RETREAT CV
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8498
Mailing Address - Country:US
Mailing Address - Phone:901-290-5567
Mailing Address - Fax:
Practice Address - Street 1:3909 COVINGTON PIKE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38135-2281
Practice Address - Country:US
Practice Address - Phone:901-377-1011
Practice Address - Fax:901-266-0463
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-02
Last Update Date:2008-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4222225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist