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NPI Code Detail

MEDICARE: MRS. MEGAN LEE KITE-HENRY PTA

MEDICARE:  MRS. MEGAN LEE KITE-HENRY  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 AssistantPTA27367FL

General Provider Information

NPI Number : 1245739606
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEGAN LEE KITE-HENRY PTA
Provider Business Mailing Address
First Line : 5925 JASPER GLEN DR
Second Line :
City : LITHIA
State : FL
Zip : 33547-4085
Country : US
Telephone Number : 813-476-4222
Fax Number :
Provider Business Practice Location Address
First Line : 1311 ASTON GARDENS CT
Second Line :
City : SUN CITY CENTER
State : FL
Zip : 33573-3824
Country : US
Telephone Number : 813-642-3424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2018
Last Update Date : 02/12/2018

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