Provider Demographics
NPI:1689701336
Name:ANDOOL, MARIA LIEZL GELI (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARIA LIEZL
Middle Name:GELI
Last Name:ANDOOL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:427 LAKE JUNE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-5655
Mailing Address - Country:US
Mailing Address - Phone:863-202-5269
Mailing Address - Fax:863-471-2015
Practice Address - Street 1:204 US HIGHWAY 27 NORTH
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:FL
Practice Address - Zip Code:33852-5655
Practice Address - Country:US
Practice Address - Phone:863-465-9500
Practice Address - Fax:863-465-9542
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 23110225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist