Provider Demographics
NPI:1235864224
Name:VANCUYK, MARIA (DPT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:VANCUYK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:RUGGERY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:12 DUNE SIDE LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-5167
Mailing Address - Country:US
Mailing Address - Phone:814-329-0887
Mailing Address - Fax:
Practice Address - Street 1:2002 RICHARD JONES RD STE 210A
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2809
Practice Address - Country:US
Practice Address - Phone:615-383-0338
Practice Address - Fax:615-383-1484
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2025-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL43759222Q00000X
TN14127225100000X
FLPT43759225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0446631Medicaid