Healthcare Provider Details

I. General information

NPI: 1457491151
Provider Name (Legal Business Name): STEPHANIE ENGELBERG P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SLIGH BLVD 1301 SLIGH BLVD
ORLANDO FL
32806-3901
US

IV. Provider business mailing address

265 ROLLINGWOOD TRL
ALTAMONTE SPRINGS FL
32714-3412
US

V. Phone/Fax

Practice location:
  • Phone: 407-649-6888
  • Fax: 407-246-0135
Mailing address:
  • Phone: 407-774-4314
  • Fax: 407-246-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT 0001048
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: