Provider Demographics
NPI:1265533376
Name:CASIANO, MARIA C (RPT)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:C
Last Name:CASIANO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LA QUINTA
Mailing Address - Street 2:CALLE 1 C 28
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698
Mailing Address - Country:US
Mailing Address - Phone:787-455-7824
Mailing Address - Fax:787-267-0234
Practice Address - Street 1:URB LA QUINTA
Practice Address - Street 2:CALLE 1 C 28
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-455-7824
Practice Address - Fax:787-267-0234
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1109225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OTH000Medicare UPIN
0080291Medicare ID - Type Unspecified