| Shawna Rae Sprout, DPT | |
|
1364 Martin Blvd Ste 5, Middle River, MD 21220-4104 | |
| (410) 686-3600 | |
| Not Available |
| Full Name | Shawna Rae Sprout |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 1364 Martin Blvd Ste 5, Middle River, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710519806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | PT34907 (Florida) | Secondary |
| 225100000X | Physical Therapist | 28779 (Maryland) | Primary |
| Provider Name | Florida Luna Care Physical Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1114542032 PECOS PAC ID: 3779991559 Enrollment ID: O20210415001126 |
| Mailing Address | Practice Location Address |
|---|---|
| Shawna Rae Sprout, DPT 1364 Martin Blvd Ste 5, Middle River, MD 21220-4104 Ph: (410) 686-3600 | Shawna Rae Sprout, DPT 1364 Martin Blvd Ste 5, Middle River, MD 21220-4104 Ph: (410) 686-3600 |
Sonali Shah, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1364 Martin Blvd Ste 5, Middle River, MD 21220 Phone: 410-686-3600 | |
Maggie Matassa, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 425 Williams Ct Ste 116, Middle River, MD 21220 Phone: 443-963-3234 | |
Miss Taila Dane De Souza, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4062 Rustico Rd, Middle River, MD 21220 Phone: 410-335-7898 |