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Individual
MRS. MARY L NASTAN
Active
Individual
MRS. MARY L NASTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225100000X
Physical Therapist
Primary
PT2278
FL
2251P0200X
Pediatric Physical Therapist
2278
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
880152500
—
FL
05
—
880152501
—
FL
Enumeration date
03/15/2006
Last updated
07/27/2011
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