Provider Demographics
NPI:1497558225
Name:ALBORNOZ, MARIANA ALEJANDRA (PT)
Entity type:Individual
Prefix:
First Name:MARIANA
Middle Name:ALEJANDRA
Last Name:ALBORNOZ
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 1:11006 WEMBLEY LANDING DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4943
Mailing Address - Country:US
Mailing Address - Phone:813-894-9044
Mailing Address - Fax:
Practice Address - Street 1:1513 SUN CITY CENTER PLZ STE C
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5390
Practice Address - Country:US
Practice Address - Phone:813-894-9044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT42813225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist