Provider Demographics
NPI:1356610653
Name:FOX, MARIA ANGELA LONTOC (RPT)
Entity type:Individual
Prefix:MISS
First Name:MARIA ANGELA
Middle Name:LONTOC
Last Name:FOX
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:MARIA ANGELA
Other - Middle Name:
Other - Last Name:AGUIRRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1126 BERKMAN CIR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6311
Mailing Address - Country:US
Mailing Address - Phone:407-610-9673
Mailing Address - Fax:
Practice Address - Street 1:12124 HIGH TECH AVE
Practice Address - Street 2:STE.300
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-8373
Practice Address - Country:US
Practice Address - Phone:407-249-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-15
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1210133225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist