Provider Demographics
NPI:1831487412
Name:CHAUHAN, MARILYNN G (RPT)
Entity Type:Individual
Prefix:
First Name:MARILYNN
Middle Name:G
Last Name:CHAUHAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12151 RHONDA TER
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-3420
Mailing Address - Country:US
Mailing Address - Phone:727-399-1538
Mailing Address - Fax:
Practice Address - Street 1:12151 RHONDA TER
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-3420
Practice Address - Country:US
Practice Address - Phone:727-399-1538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3411225100000X
FLPT5947225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist