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General NPI Number Information
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NPI Number | 1669140463
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Entity Type | Individual
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Provider Name | VALERIIA LEBEDEVA PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/06/2021
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Last Update Date | 09/06/2021
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Provider Practice Location Address
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Address Line | 1000 S DIXIE HWY
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-7044
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Country | US
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Telephone | 954-458-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 4242 NW 66TH DR
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City | COCONUT CREEK
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State | FL
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Zip | 33073-2012
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Country | US
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Telephone | 929-290-2761
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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 | PT37354
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License Number State | FL
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