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NPI Code Detail

MEDICARE: LAUREN LITTLEWOOD PTA

MEDICARE:   LAUREN  LITTLEWOOD  PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA27548FL

General Provider Information

NPI Number : 1053833103
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN LITTLEWOOD PTA
Provider Business Mailing Address
First Line : 7547 YELLOW FIN DR UNIT 101
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-2100
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7547 YELLOW FIN DR UNIT 101
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-2100
Country : US
Telephone Number : 407-697-4329
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2017
Last Update Date : 07/11/2017

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Directions to “ LAUREN LITTLEWOOD PTA” Practice Location

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