Healthcare Provider Details

I. General information

NPI: 1124081088
Provider Name (Legal Business Name): PETER MCHUGH MSPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N ALAFAYA TRL STE 900
ORLANDO FL
32826-4737
US

IV. Provider business mailing address

1900 N ALAFAYA TRL STE 900
ORLANDO FL
32826-4737
US

V. Phone/Fax

Practice location:
  • Phone: 407-514-3657
  • Fax: 407-381-1971
Mailing address:
  • Phone: 407-514-3657
  • Fax: 407-381-1971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberQA005178
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT36857
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: