Individual
KIMBERLY MARIE MAUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3876 HIGHWAY 90, ANDREWS INSTITUTE REHABILITATION, PACE, FL 32571
(448) 227-7075
Mailing address
5427 PEACH DR, MILTON, FL 32571-2773
(301) 908-1356
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
Primary
32737
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A1619
LICENSE#
MD
Enumeration date
08/30/2006
Last updated
12/06/2024
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