Healthcare Provider Details

I. General information

NPI: 1073336673
Provider Name (Legal Business Name): WILLIAM LEE HATAWAY PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 N ORLANDO AVE
WINTER PARK FL
32789-2911
US

IV. Provider business mailing address

454 RINEHART RD STE 1001
LAKE MARY FL
32746-5251
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-7600
  • Fax:
Mailing address:
  • Phone: 407-206-4590
  • Fax: 407-206-4591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT41646
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: