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NPI Code Detail

MEDICARE: KAYLEIGH LEWELLYN

MEDICARE: KAYLEIGH LEWELLYN
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
1225100000XPhysical TherapistPT871869DC

General Provider Information

NPI Number : 1265804645
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEIGH LEWELLYN
Provider Business Mailing Address
First Line : 500 E CENTRAL AVE
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33880-3094
Country : US
Telephone Number : 863-293-1191
Fax Number :
Provider Business Practice Location Address
First Line : 3000 WOODMONT AVE
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-3800
Country : US
Telephone Number : 863-293-1191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2015
Last Update Date : 06/27/2018

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Directions to “ KAYLEIGH LEWELLYN ” Practice Location

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