Healthcare Provider Details

I. General information

NPI: 1780565143
Provider Name (Legal Business Name): CONNECTIVE PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 CHERRY LAUREL DR STE 171
SANFORD FL
32771-8881
US

IV. Provider business mailing address

2480 CHERRY LAUREL DR STE 171
SANFORD FL
32771-8881
US

V. Phone/Fax

Practice location:
  • Phone: 407-205-7949
  • Fax:
Mailing address:
  • Phone: 407-205-7949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARISSA LITTMAN
Title or Position: OWNER
Credential: DPT
Phone: 407-205-7949