Provider Demographics
NPI:1821329368
Name:FELIX, MAUREEN (PT)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:FELIX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:ALMODOVAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2441 E PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-5101
Mailing Address - Country:US
Mailing Address - Phone:619-757-9227
Mailing Address - Fax:619-336-0201
Practice Address - Street 1:2441 E PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-5101
Practice Address - Country:US
Practice Address - Phone:619-757-9227
Practice Address - Fax:619-336-0201
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist