Provider Demographics
NPI:1760812903
Name:MAURICI, RON (LPTA)
Entity Type:Individual
Prefix:MR
First Name:RON
Middle Name:
Last Name:MAURICI
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18252 HOLLAND HOUSE LOOP
Mailing Address - Street 2:
Mailing Address - City:LAND O'LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638
Mailing Address - Country:US
Mailing Address - Phone:813-735-9139
Mailing Address - Fax:
Practice Address - Street 1:18252 HOLLAND HOUSE LOOP
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-8131
Practice Address - Country:US
Practice Address - Phone:813-735-9139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA23075225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant