Provider Demographics
NPI:1669418018
Name:DALY, MAUREEN DUNLEAVY (DPT)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:DUNLEAVY
Last Name:DALY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:DUNLEAVY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:15210 AMBERLY DR
Mailing Address - Street 2:APT 1823
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2196
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:214 W ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-7156
Practice Address - Country:US
Practice Address - Phone:813-707-1509
Practice Address - Fax:813-754-7864
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 21259225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist