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General NPI Number Information
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NPI Number | 1295280626
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Entity Type | Individual
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Provider Name | NEELAM KANSARA PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 2190 E COUNTY ROAD 540A
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City | LAKELAND
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State | FL
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Zip | 33813
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Country | US
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Telephone | 863-607-3699
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Fax | 866-264-8519
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Provider Business Mailing Address
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Address Line | 1600 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-3019
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Country | US
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Telephone | 863-680-7000
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Fax | 866-264-8519
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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 | PT31691
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License Number State | FL
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