Individual
MAVERICK NAGUIT HERRERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4692 RIDGE POINTE DR, PACE, FL 32571-1318
(850) 776-4208
Mailing address
4692 RIDGE POINTE DR, PACE, FL 32571-1318
(850) 776-4208
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA27685
FL
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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