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Organization
FUNCTION HEALTH AND WELLNESS
Active
Organization
FUNCTION HEALTH AND WELLNESS
Active
Other names
Fyziotherapy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL LAVARIAS PT (ADMINISTRATOR)
(386) 259-9838
Entity
Organization
Contact information
Practice address
829 DELTONA BLVD, SUITE 204, DELTONA, FL 32725-7132
(386) 259-9838
(386) 259-9834
Mailing address
829 DELTONA BLVD, SUITE 204, DELTONA, FL 32725-7132
(386) 259-9838
(386) 259-9834
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010925600
—
FL
Enumeration date
10/17/2013
Last updated
02/05/2020
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