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General NPI Number Information
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NPI Number | 1245739606
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Entity Type | Individual
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Provider Name | MEGAN LEE KITE-HENRY PTA
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Gender | Female
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 02/12/2018
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Provider Practice Location Address
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Address Line | 1311 ASTON GARDENS CT
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-3824
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Country | US
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Telephone | 813-642-3424
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Fax |
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Provider Business Mailing Address
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Address Line | 5925 JASPER GLEN DR
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City | LITHIA
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State | FL
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Zip | 33547-4085
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Country | US
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Telephone | 813-476-4222
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA27367
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License Number State | FL
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