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General NPI Number Information
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NPI Number | 1487536223
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Entity Type | Organization
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Legal Business Name | LITTLE PHYSIATRY CONSULTANTS LLC
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 198 SW REAL TER
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City | LAKE CITY
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State | FL
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Zip | 32025-1504
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Country | US
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Telephone | 386-227-5224
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Fax | 817-284-9859
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Provider Business Mailing Address
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Address Line | 637 NW RODEO CT
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City | LAKE CITY
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State | FL
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Zip | 32055-8018
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Country | US
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Telephone | 817-284-9850
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Fax | 817-284-9859
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Authorized Official
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Title or Position | MANAGER
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Name | LISA LEE
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Credential |
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Telephone | 817-284-9850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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