| |
587 E State Road 434 Unit 1021, Longwood, FL 32750-5284 | |
(321) 972-3238 | |
(321) 972-3590 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 587 E State Road 434 Unit 1021, Longwood, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598307993 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2251E1300X | Physical Therapist - Electrophysiology, Clinical | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Nilma Zuleika Elias-santiago |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1700038486 PECOS PAC ID: 3971729534 Enrollment ID: I20140717001527 |
Mailing Address | Practice Location Address |
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587 E State Road 434 Unit 1021, Longwood, FL 32750-5284 Ph: (321) 972-3238 | 587 E State Road 434 Unit 1021, Longwood, FL 32750-5284 Ph: (321) 972-3238 |