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NPI 1982688875

NPI 1982688875 : JUDI M SCHACK PT : ORLANDO, FL

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General NPI Number Information
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    NPI Number           |    1982688875
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    Entity Type          |    Individual 
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    Provider Name        |    JUDI M SCHACK PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/04/2005
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    Last Update Date     |    09/11/2025
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Provider Practice Location Address
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    Address Line         |    10244 E COLONIAL DR SUITE 202
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32817-4374
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    Country              |    US
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    Telephone            |    407-282-1003
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    Fax                  |    407-282-5560
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Provider Business Mailing Address
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    Address Line         |    10244 E COLONIAL DR SUITE 202
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32817-4374
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    Country              |    US
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    Telephone            |    407-282-1003
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    Fax                  |    407-282-5560
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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       |    PT0004841
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    License Number State |    FL
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Taxonomy #2
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    Taxonomy Code        |    2251G0304X
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    Taxonomy Name        |    Geriatric Physical Therapist
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    License Number       |    PT0004841
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    License Number State |    FL
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Taxonomy #3
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    Taxonomy Code        |    2251S0007X
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    Taxonomy Name        |    Sports Physical Therapist
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    License Number       |    PT0004841
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    License Number State |    FL
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Taxonomy #4
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    Taxonomy Code        |    2251X0800X
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    Taxonomy Name        |    Orthopedic Physical Therapist
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    License Number       |    PT0004841
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    License Number State |    FL
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