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General NPI Number Information
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NPI Number | 1497386064
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Entity Type | Organization
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Legal Business Name | HOME BASED PEDIATRIC PHYSICAL THERAPY SERVICES LLC
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Dates
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Enumeration Date | 01/31/2020
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 929 BERESFORD WAY
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City | LAKE MARY
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State | FL
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Zip | 32746-6435
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Country | US
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Telephone | 407-687-7422
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Fax |
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Provider Business Mailing Address
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Address Line | 929 BERESFORD WAY
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City | LAKE MARY
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State | FL
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Zip | 32746-6435
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINDA FERRAN
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Credential |
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Telephone | 407-687-7422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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