Provider Demographics
NPI:1043526320
Name:SANOGUET, MARIE L
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:L
Last Name:SANOGUET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7535 SW 152ND AVE APT C108
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2379
Mailing Address - Country:US
Mailing Address - Phone:305-528-8146
Mailing Address - Fax:
Practice Address - Street 1:13335 SW 124TH ST STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7513
Practice Address - Country:US
Practice Address - Phone:305-378-5247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 25483225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist