Provider Demographics
NPI:1104680537
Name:SHUN, ROSE MARIE ARRIOLA (PT)
Entity type:Individual
Prefix:
First Name:ROSE MARIE
Middle Name:ARRIOLA
Last Name:SHUN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4947 SW 45TH CIR
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-9759
Mailing Address - Country:US
Mailing Address - Phone:207-669-0414
Mailing Address - Fax:
Practice Address - Street 1:4947 SW 45TH CIR
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-9759
Practice Address - Country:US
Practice Address - Phone:207-669-0414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL40712225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist