Basic Information
| Provider Information | |||||||||
| NPI: | 1689895609 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LASKY | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | RAE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 508 NEPTUNE BAY CIR | ||||||||
| Address2: | APT. 5086 | ||||||||
| City: | SAINT CLOUD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347697022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3217667581 | ||||||||
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| Practice Location | |||||||||
| Address1: | 311 W BASS ST | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347415011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078705959 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT23111 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.