Basic Information
| Provider Information | |||||||||
| NPI: | 1003002056 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OUANO | ||||||||
| FirstName: | MAY | ||||||||
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| Credential: | PT | ||||||||
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| 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 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT773 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | PT773 | 01 | FL | STATE LICENSE | OTHER |