Healthcare Provider Details

I. General information

NPI: 1932049053
Provider Name (Legal Business Name): LAWRENCE L CAIN JR. PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 E FLETCHER AVE
TAMPA FL
33613-4613
US

IV. Provider business mailing address

18001 RICHMOND PLACE DR APT 1121
TAMPA FL
33647-1749
US

V. Phone/Fax

Practice location:
  • Phone: 813-971-6000
  • Fax:
Mailing address:
  • Phone: 352-262-7404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA23694
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: