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General NPI Number Information
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NPI Number | 1801687538
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Entity Type | Individual
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Provider Name | VICKI LI DPT
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Gender | Female
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 1400 SE GOLDTREE DR STE 205
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-7583
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Country | US
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Telephone | 772-335-7966
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Fax |
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Provider Business Mailing Address
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Address Line | 7296 SE SEAGATE LN
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City | STUART
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State | FL
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Zip | 34997-2161
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Country | US
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Telephone | 772-285-3177
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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 | PT40696
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License Number State | FL
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