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General NPI Number Information
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NPI Number | 1144841883
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Entity Type | Individual
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Provider Name | LISA MARIE LEPINE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 1495 S VOLUSIA AVE STE 101
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City | ORANGE CITY
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State | FL
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Zip | 32763-7047
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Country | US
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Telephone | 386-401-6100
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Fax | 386-960-0551
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Provider Business Mailing Address
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Address Line | 172 COUNTY ROUTE 63
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City | OSWEGO
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State | NY
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Zip | 13126-5100
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Country | US
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Telephone | 315-529-8724
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 35628
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License Number State | FL
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