Provider Demographics
NPI:1760553606
Name:MACLAREN, TREVOR MARIE (MS, PT)
Entity Type:Individual
Prefix:MRS
First Name:TREVOR
Middle Name:MARIE
Last Name:MACLAREN
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4230 KING EDWARD DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-2651
Mailing Address - Country:US
Mailing Address - Phone:407-432-7149
Mailing Address - Fax:
Practice Address - Street 1:5423 LAKE HOWELL RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1033
Practice Address - Country:US
Practice Address - Phone:407-679-7837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT214432251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics