Provider Demographics
NPI:1922319516
Name:BALAJADIA, MARIA REALEZA (RPT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:REALEZA
Last Name:BALAJADIA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:REALEZA
Other - Last Name:BALAJADIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:5552 OAKWORTH PL
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-7052
Mailing Address - Country:US
Mailing Address - Phone:407-893-1977
Mailing Address - Fax:
Practice Address - Street 1:5552 OAKWORTH PL
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-7052
Practice Address - Country:US
Practice Address - Phone:407-893-1977
Practice Address - Fax:407-260-0817
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25305225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist