Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
LEGACY HEALTHCARE INC
Active
Organization
LEGACY HEALTHCARE INC
Active
Other names
Legacy Physical Therapy & Sports Training
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CESAR CHACON (ADMINISTRATOR)
(941) 302-9400
Entity
Organization
Contact information
Practice address
8175 US HIGHWAY 301 N, PARRISH, FL 34219-8669
(941) 729-0003
(941) 729-0004
Mailing address
PO BOX 1156, ELLENTON, FL 34222-1156
(941) 729-0003
(941) 729-0004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2989794
AETNA GROUP PROV NUMBER
FL
05
—
888322000
—
FL
Enumeration date
05/30/2006
Last updated
03/22/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up