Provider Demographics
NPI:1356522411
Name:THAKORE, MAULIKA (PT)
Entity type:Individual
Prefix:
First Name:MAULIKA
Middle Name:
Last Name:THAKORE
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 1:5205 PIPER LN
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-5465
Mailing Address - Country:US
Mailing Address - Phone:813-843-2401
Mailing Address - Fax:407-732-6597
Practice Address - Street 1:875 WALLACE CT STE C
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2161
Practice Address - Country:US
Practice Address - Phone:407-710-8956
Practice Address - Fax:407-732-6597
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010124302251X0800X
FLPT30276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic