Provider Demographics
NPI:1710183579
Name:KHASHI, MARIA (RPT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:KHASHI
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:TIBAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3109 GREEN HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-6471
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:611 S 13TH ST
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4054
Practice Address - Country:US
Practice Address - Phone:214-404-0245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 23162225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist