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General NPI Number Information
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NPI Number | 1245773068
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Entity Type | Organization
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Legal Business Name | DAMANA PHYSICAL THERAPY CENTER, P.A
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 11/28/2016
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Provider Practice Location Address
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Address Line | 220 ALAFAYA WOODS BLVD SUITE 1002
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City | OVIEDO
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State | FL
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Zip | 32765-6212
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Country | US
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Telephone | 407-580-4226
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Fax |
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Provider Business Mailing Address
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Address Line | 220 ALAFAYA WOODS BLVD SUITE 1002
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City | OVIEDO
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State | FL
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Zip | 32765-6212
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Country | US
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Telephone | 407-580-4226
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LALLA IHSSAN TOUHAMI EL OUAZZANI
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Credential | P.T
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Telephone | 407-580-4226
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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 | PT31929
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License Number State | FL
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