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General NPI Number Information
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NPI Number | 1760851851
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Entity Type | Individual
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Provider Name | KAITLYN POLLITT PTA
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Gender | Female
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Dates
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Enumeration Date | 09/18/2015
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 340 HEALD WAY SUITE 232
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City | THE VILLAGES
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State | FL
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Zip | 32162
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Country | US
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Telephone | 352-330-1154
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Fax | 352-330-1004
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Provider Business Mailing Address
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Address Line | 33615 LAKE MYRTLE BLVD
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City | LEESBURG
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State | FL
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Zip | 34748
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Country | US
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Telephone | 352-728-6636
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Fax | 352-787-4522
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA25961
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License Number State | FL
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