MAURICIO ELIZONDO (NPI# 1679041081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679041081 |
| Entity Type | Individual |
| Full Name | MAURICIO ELIZONDO |
| Credential | PT, DPT, ATC, CSCS |
| Practice Address |
201 Atp Tour Blvd Ponte Vedra Beach FL 32082-3211 |
| Mailing Address |
16627 Fishhawk Blvd Lithia FL 33547-3800 |
| Practice Telephone | 4802084508 |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2018-11-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251S0007X |
Physical Therapist Specialization: Sports |
PT33327 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
201 ATP TOUR BLVD |
| City | PONTE VEDRA BEACH |
| State | FL |
| Zip Code | 32082-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576818 | Specialty Eye Surgeons, Pa | Ophthalmology | 240 Ponte Vedra Boulevard, Suite 202, Ponte Vedra Beach, FL 32082 | 2020-07-23 |
| 1649820630 | Ponte Vedra Endodontics | Dentist | 822 A1a North, Ste 314, Ponte Vedra Beach, FL 32082 | 2019-09-12 |
| 1568988129 | Mustafa Bakir | General Practice | 1102 A1a, Ponte Vedra Beach, FL 32082 | 2017-08-16 |
| 1457890584 | Angelyn Sorgen | Nurse Practitioner | 1102 Hwy A1a, Suite 104, Ponte Vedra Beach, FL 32082 | 2017-02-22 |
| 1033575121 | Balanced Physician Care Pa | Family Medicine | 115 Professional Park Drive, Suite 104, Ponte Vedra Beach, FL 32082 | 2016-01-06 |
| 1528436060 | Robert Thompson II | Chiropractor | 135 Professional Drive, Suite 105, Ponte Vedra Beach, FL 32082 | 2015-09-14 |
| 1144628439 | Integrative Medical Group, Usa, LLC | Clinic/Center | 1102 A1a North, Suite 104, Ponte Vedra Beach, FL 32082 | 2014-12-18 |
| 1811308901 | Janice Wachtel, Phd, LLC | Psychologist | 100 Executive Way, Suite 110, Ponte Vedra Beach, FL 32082 | 2014-05-12 |
| 1578991154 | Nicole Theiler | Counselor | 171 Canal Blvd, Ponte Vedra Beach, FL 32082 | 2013-10-17 |
| 1982948006 | Daisamma Varghese | Nurse Practitioner | 860 A1an, Ponte Vedra, FL 32082 | 2012-11-15 |
| Find all providers in zip 32082 | ||||
| Taxonomy Code | 2251S0007X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871695585 | Brett Richard Jorgenson | Physical Therapist | 236 Ponte Vedra Park Drive, Suite 300, Ponte Vedra Beach, FL 32082 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538721907 | Revolution Sports and Performance LLC | Physical Therapist | 27774 Autumn Breeze Cir, Wesley Chapel, FL 33544-7839 | 2019-07-05 |
| 1790242105 | Ignacio Ray Barajas | Physical Therapist | 11723 Gulf Beach Hwy, Pensacola, FL 32507-9143 | 2019-02-22 |
| 1194209205 | Jack Malafronte | Physical Therapist | 2221 S Dale Mabry Hwy, Tampa, FL 33629-6313 | 2018-09-25 |
| 1881109791 | Michael R Preciados | Physical Therapist | 2999 Ne 191st St Ste 230, Aventura, FL 33180-3115 | 2017-12-14 |
| 1467970277 | Naples Premier Physical Therapy Inc | Physical Therapist | 3940 Prospect Ave Ste 103, Naples, FL 34104-3745 | 2017-08-31 |
| 1134643356 | Thomas Mulligan | Physical Therapist | 401 Channelside Dr, Tampa, FL 33602-5400 | 2017-07-29 |
| 1962952333 | Jordan Clayborne | Physical Therapist | 4747 N Ocean Dr Ste 261, Lauderdale By The Sea, FL 33308-2956 | 2016-10-10 |
| 1043764483 | Tonny Vandehee | Physical Therapist | 3264 Pacific Dr, Naples, FL 34119-8672 | 2016-08-14 |
| 1861848517 | Physioworks of Miami | Physical Therapist | 3617 E Sandpiper Dr, #5, Boynton Beach, FL 33436-2463 | 2016-05-12 |
| 1538433552 | Physical Therapy & Sports Rehab LLC | Physical Therapist | 1290 Old Congress Ave., West Palm Beach, FL 33409 | 2012-03-08 |
| Find all providers with the same taxonomy | ||||
| City | PONTE VEDRA BEACH |
| Zip Code | 32082 |
Please comment or provide details below to improve the information on MAURICIO ELIZONDO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.