Healthcare Provider Details

I. General information

NPI: 1255784765
Provider Name (Legal Business Name): MELINDA HUFFORD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WAYMONT CT SUITE 120
LAKE MARY FL
32746-3412
US

IV. Provider business mailing address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-0399
  • Fax:
Mailing address:
  • Phone: 407-303-9603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number27427
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: