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General NPI Number Information
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NPI Number | 1477950251
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Entity Type | Individual
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Provider Name | LYNNE VIRANT PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/23/2014
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 3012 E CERVANTES ST
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City | PENSACOLA
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State | FL
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Zip | 32503-6421
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Country | US
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Telephone | 850-450-1118
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Fax |
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Provider Business Mailing Address
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Address Line | 2 PORTOFINO DR STE 1702
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City | PENSACOLA BEACH
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State | FL
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Zip | 32561-2489
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Country | US
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Telephone | 850-450-1118
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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 | PT 29839
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License Number State | FL
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