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NPI Code Detail

MEDICARE: SPORTSCARE INSTITUTE, LLC

MEDICARE: SPORTSCARE INSTITUTE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2225XH1200XHand Occupational Therapist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1336466671
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPORTSCARE INSTITUTE, LLC
Provider Business Mailing Address
First Line : P.O. BOX 2265
Second Line :
City : WINTER PARK
State : FL
Zip : 32790
Country : US
Telephone Number : 407-960-2806
Fax Number :
Provider Business Practice Location Address
First Line : 231 N NEW YORK AVE
Second Line :
City : WINTER PARK
State : FL
Zip : 32789-3117
Country : US
Telephone Number : 407-599-3700
Fax Number : 407-599-3701
Authorized Official
Title or Position : CONTRACT MANAGER
Name : ELIZABETH A LANTIGUA
Credential :
Telephone Number : 973-887-9000
Provider Enumeration Date : 04/27/2010
Last Update Date : 09/20/2017

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Directions to “SPORTSCARE INSTITUTE, LLC ” Practice Location

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