Provider Demographics
NPI:1992003909
Name:FINNERTY, MAURA B (PTA)
Entity Type:Individual
Prefix:MS
First Name:MAURA
Middle Name:B
Last Name:FINNERTY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 10TH AVE W
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-5032
Mailing Address - Country:US
Mailing Address - Phone:941-722-3582
Mailing Address - Fax:
Practice Address - Street 1:410 10TH AVE W
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-5032
Practice Address - Country:US
Practice Address - Phone:941-722-3582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2015-12-09
Deactivation Date:2012-10-09
Deactivation Code:
Reactivation Date:2015-11-30
Provider Licenses
StateLicense IDTaxonomies
FLPTA19493225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant