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General NPI Number Information
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NPI Number | 1003854704
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Entity Type | Organization
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Legal Business Name | PT CONNECTION INC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1822 GRASMERE DR
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City | APOPKA
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State | FL
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Zip | 32703-7639
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Country | US
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Telephone | 407-886-2152
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Fax | 407-886-2152
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Provider Business Mailing Address
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Address Line | 1822 GRASMERE DR
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City | APOPKA
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State | FL
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Zip | 32703-7639
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Country | US
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Telephone | 407-886-2152
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Fax | 407-886-2152
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Authorized Official
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Title or Position | PRESIDENT
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Name | MYRA SHEILA BAQUIR JAVIER
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Credential | RPT
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Telephone | 407-435-4167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 15122
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License Number State | FL
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