Marilyn Suero Laconsay

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6565 Issued in FL

Practice address

27299 Riverview Center Blvd Ste 201
Bonita Springs, FL 34134-4322

Phone

(239) 676-2080

Fax

(239) 676-2089

NPI assigned

Mar 25, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1508326539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27299 RIVERVIEW CENTER BLVD STE 201",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344322",
            "telephone_number": "239-676-2080",
            "fax_number": "239-676-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27299 RIVERVIEW CENTER BLVD STE 201",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344322",
            "telephone_number": "239-676-2080",
            "fax_number": "239-676-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACONSAY",
        "first_name": "MARILYN",
        "middle_name": "SUERO",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT6565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tami L Kuhlman, M.D.
• William J Kuzbyt, PSYD
• Kynder Home Health Agency
• Athina Lynn Kyritsis, M.D.
• Laboratory Corporation of America
• Leonard A Lado, MD
• Michelle Laforme, OTR-L
• Erin Lake, ARNP, FNP-BC
• Daniel C Lamb, LCSW
• Dianna Kaye Lamb, RN

• Physical Therapist in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.