Provider Demographics
NPI:1962656546
Name:YANES ESCOBAR, MARIA DEL ROSARIO (PT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:DEL ROSARIO
Last Name:YANES ESCOBAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28050 US HIGHWAY 19 N STE 100
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2600
Mailing Address - Country:US
Mailing Address - Phone:727-210-2225
Mailing Address - Fax:727-210-0880
Practice Address - Street 1:28050 US HIGHWAY 19 N STE 100
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2600
Practice Address - Country:US
Practice Address - Phone:727-210-2225
Practice Address - Fax:727-210-0880
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20736225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106898OtherMEDICARE ID