Provider Demographics
NPI:1871203372
Name:CAVALLI DE OLIVEIRA, MARILIA
Entity type:Individual
Prefix:
First Name:MARILIA
Middle Name:
Last Name:CAVALLI DE OLIVEIRA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 CRAGMERE LOOP
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5520
Mailing Address - Country:US
Mailing Address - Phone:786-862-3306
Mailing Address - Fax:
Practice Address - Street 1:1919 E HIGHWAY 50 STE 103
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1975
Practice Address - Country:US
Practice Address - Phone:352-717-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-25
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT39696OtherPT