Provider Demographics
NPI:1285898874
Name:GEDEON, MARIE-CARMEL (PT)
Entity type:Individual
Prefix:MS
First Name:MARIE-CARMEL
Middle Name:
Last Name:GEDEON
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 1:9202 DAYFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2815
Mailing Address - Country:US
Mailing Address - Phone:813-973-1474
Mailing Address - Fax:813-973-1474
Practice Address - Street 1:9202 DAYFLOWER DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2815
Practice Address - Country:US
Practice Address - Phone:813-973-1474
Practice Address - Fax:813-973-1474
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT22813225100000X
NY01298-7225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist