Healthcare Provider Details

I. General information

NPI: 1356207047
Provider Name (Legal Business Name): LEIPHKA CARMIL DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2025
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6191 ORANGE DR STE 6167
DAVIE FL
33314-3454
US

IV. Provider business mailing address

6191 ORANGE DR STE 6167
DAVIE FL
33314-3454
US

V. Phone/Fax

Practice location:
  • Phone: 954-800-4078
  • Fax: 954-369-1444
Mailing address:
  • Phone: 954-800-4078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT43979
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: