Provider Demographics
NPI:1871275453
Name:ANZUETO, FRANCISCO SAMUEL (PTA)
Entity type:Individual
Prefix:MR
First Name:FRANCISCO
Middle Name:SAMUEL
Last Name:ANZUETO
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1825 MONTEVIDEO RD
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:MD
Mailing Address - Zip Code:20794-9743
Mailing Address - Country:US
Mailing Address - Phone:301-395-8100
Mailing Address - Fax:
Practice Address - Street 1:19851 OBSERVATION DR STE 450
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4148
Practice Address - Country:US
Practice Address - Phone:301-977-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA5829225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant