Healthcare Provider Details

I. General information

NPI: 1306239967
Provider Name (Legal Business Name): ADVANCED PHYSICAL THERAPY OF CENTRAL FLORIDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2015
Last Update Date: 09/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11962 COUNTY ROAD 101 STE 104
THE VILLAGES FL
32162-9336
US

IV. Provider business mailing address

1202 SW 17TH STREET #201-229
OCALA FL
34471-4421
US

V. Phone/Fax

Practice location:
  • Phone: 352-693-3378
  • Fax: 888-758-9645
Mailing address:
  • Phone: 352-693-3378
  • Fax: 888-758-9645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LESTER A HAMMOND
Title or Position: CEO
Credential: PT
Phone: 352-693-3378