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General NPI Number Information
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NPI Number | 1639474547
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Entity Type | Organization
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Legal Business Name | LYMPHEDEMA AND PHYSICAL THERAPY SPECIALISTS, LLC
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 333 N HIGHWAY 27
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City | CLERMONT
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State | FL
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Zip | 34711-2440
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Country | US
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Telephone | 352-432-3910
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Fax | 352-432-3911
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Provider Business Mailing Address
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Address Line | 3390 PLAYERS POINT LOOP
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City | APOPKA
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State | FL
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Zip | 32712-4771
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Country | US
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Telephone | 321-356-6460
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Fax | 407-889-4507
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Authorized Official
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Title or Position | OWNER
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Name | MRS. HUYEN LU VITALE
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Credential | PT
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Telephone | 321-356-6460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT21120
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License Number State | FL
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