Basic Information
Provider Information
NPI: 1003002056
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OUANO
FirstName: MAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10901 PINTO DR
Address2:  
City: HUDSON
State: FL
PostalCode: 346692572
CountryCode: US
TelephoneNumber: 7279922039
FaxNumber: 7278683838
Practice Location
Address1: 7236 STATE ROAD 52
Address2: SUITE 4
City: BAYONET POINT
State: FL
PostalCode: 346676789
CountryCode: US
TelephoneNumber: 7279922039
FaxNumber: 7278473529
Other Information
ProviderEnumerationDate: 09/23/2007
LastUpdateDate: 10/19/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT773FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
PT77301FLSTATE LICENSEOTHER


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