Basic Information
Provider Information
NPI: 1851432108
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALMEIDA
FirstName: FELIPPE
MiddleName: SOUZA
NamePrefix:  
NameSuffix:  
Credential: ATC, LAT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7636 BAY PORT RD
Address2:  
City: ORLANDO
State: FL
PostalCode: 328195503
CountryCode: US
TelephoneNumber: 4076661816
FaxNumber:  
Practice Location
Address1: 311 W BASS ST
Address2:  
City: KISSIMMEE
State: FL
PostalCode: 347415011
CountryCode: US
TelephoneNumber: 4078705959
FaxNumber: 4079336468
Other Information
ProviderEnumerationDate: 02/09/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2255A2300XAL# 2187FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer

No ID Information.


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