Healthcare Provider Details

I. General information

NPI: 1629888425
Provider Name (Legal Business Name): LEVEL UP PHYSICAL THERAPY RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1998 SETTER AVE
SAINT CLOUD FL
34771-7997
US

IV. Provider business mailing address

3962 GRASSLAND DR
ORLANDO FL
32824-9027
US

V. Phone/Fax

Practice location:
  • Phone: 786-344-8158
  • Fax:
Mailing address:
  • Phone: 786-344-8158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VANESSA ANGEL
Title or Position: OWNER
Credential: DPT
Phone: 786-344-8158