Healthcare Provider Details
I. General information
NPI: 1346449741
Provider Name (Legal Business Name): SHARI LEONE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/16/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5979 VINELAND RD SUITE 304
ORLANDO FL
32819-7800
US
IV. Provider business mailing address
2137 LAKE DEBRA DR
ORLANDO FL
32835-6379
US
V. Phone/Fax
- Phone: 407-354-3906
- Fax:
- Phone: 407-616-4344
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | PT22275 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: