Doctor Name: | MR. MICAH OWEN MARAZON |
NPI Number: | 1124300546 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.T. |
License Number: | PT25697 |
Business Practice Address: | 1715 Cape Coral Pkwy W Ste 13 Cape Coral, FL - 339146914 |
Business Phone Number: | 2395420900 |
Business Fax Number: | 2395421802 |
Mailing Address: | 1715 Cape Coral Pkwy W, Ste 13 CAPE CORAL |
State: | FL |
Postal Code: | 339146914 |
Phone Number: | 2395420900 |
Fax Number: | 2395421802 |
NPI Enumeration Date: | 09/12/2011 |
NPI Last Update Date: | 10/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT25697 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |