Provider Demographics
NPI:1760687875
Name:LAMANILAO, ASHER GONZAGA (RPT)
Entity Type:Individual
Prefix:MR
First Name:ASHER
Middle Name:GONZAGA
Last Name:LAMANILAO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8229 60TH STREET CIR E
Mailing Address - Street 2:APT 502
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-3117
Mailing Address - Country:US
Mailing Address - Phone:941-350-3653
Mailing Address - Fax:
Practice Address - Street 1:5899 WHITFIELD AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-6152
Practice Address - Country:US
Practice Address - Phone:941-320-8845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23352225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist