Healthcare Provider Details

I. General information

NPI: 1760427975
Provider Name (Legal Business Name): FCHR PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 8TH ST
CLERMONT FL
34711-2159
US

IV. Provider business mailing address

PO BOX 135366
CLERMONT FL
34713-5366
US

V. Phone/Fax

Practice location:
  • Phone: 352-243-4422
  • Fax:
Mailing address:
  • Phone: 352-243-9341
  • Fax: 352-243-8293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT20389
License Number StateFL

VIII. Authorized Official

Name: MR. LUKE T KRON
Title or Position: PRESIDENT
Credential: PT
Phone: 352-243-9341