Healthcare Provider Details

I. General information

NPI: 1003006073
Provider Name (Legal Business Name): CATHERINE ANN WEIBEL MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 12/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 S OSCEOLA AVE APT 1101
ORLANDO FL
32801-2811
US

IV. Provider business mailing address

260 S OSCEOLA AVE APT 1101
ORLANDO FL
32801-2811
US

V. Phone/Fax

Practice location:
  • Phone: 772-532-5812
  • Fax:
Mailing address:
  • Phone: 772-532-5812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number70014519
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number18784
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: