Basic Information
| Provider Information | |||||||||
| NPI: | 1881085272 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KUMAR | ||||||||
| FirstName: | NEETIKA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 479 TERRANOVA ST | ||||||||
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| City: | WINTER HAVEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338843431 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 35902 HWY 27 | ||||||||
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| City: | HAINES CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338443737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8634211777 | ||||||||
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| ProviderEnumerationDate: | 02/06/2015 | ||||||||
| LastUpdateDate: | 02/06/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT 30016 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.