Provider Demographics
NPI:1023444304
Name:COSCHIGNANO, RUTH LORINE (LMT)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:LORINE
Last Name:COSCHIGNANO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3461 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-3601
Mailing Address - Country:US
Mailing Address - Phone:407-250-6749
Mailing Address - Fax:407-250-6749
Practice Address - Street 1:3461 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-3601
Practice Address - Country:US
Practice Address - Phone:407-250-6749
Practice Address - Fax:407-250-6749
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA73246172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist