Healthcare Provider Details

I. General information

NPI: 1588583876
Provider Name (Legal Business Name): LEGACY PHYSICAL THERAPY & BALANCE SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9950 COCONUT RD
ESTERO FL
34135-8121
US

IV. Provider business mailing address

9920 ADRIATICA LOOP UNIT 102
FORT MYERS FL
33967-5903
US

V. Phone/Fax

Practice location:
  • Phone: 239-498-8888
  • Fax:
Mailing address:
  • Phone: 239-380-7339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH ESIO LUCCHESI
Title or Position: OWNER/MANAGING MEMBER
Credential: DPT, PT
Phone: 239-380-7339