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Organization
LAKE AREA PHYSICAL THERAPY INC
Active
Organization
LAKE AREA PHYSICAL THERAPY INC
Active
Other names
Lake Area Physical Therapy & Aquatics Inc., Lake Area Physical Therapy & Aquatics
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA HODGES PT (OWNER)
(352) 475-3113
Entity
Organization
Contact information
Practice address
25727 NE STATE RD 26, MELROSE, FL 32666-1099
(352) 475-3113
(352) 475-5796
Mailing address
PO BOX 1099, MELROSE, FL 32666-1099
(352) 475-3113
(352) 475-5796
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103999
AVMED PROVIDER #
FL
01
—
106944
MEDICARE
FL
01
—
5941306
AETNA PROV#
FL
05
—
880554700
—
FL
01
—
R8J
BLUE CROSS PROV#
FL
Enumeration date
02/05/2007
Last updated
06/16/2018
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