Healthcare Provider Details

I. General information

NPI: 1689196214
Provider Name (Legal Business Name): MARISSA LITTMAN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 07/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CELEBRATION PL
CELEBRATION FL
34747-4970
US

IV. Provider business mailing address

10122 RICHARDSON CT
ORLANDO FL
32825-3826
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-4003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number31581
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: