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LITO B VILLANUEVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
12622 PORTMARNOCK DR, ODESSA, FL 33556-5414
(573) 353-0285
Mailing address
12622 PORTMARNOCK DR, ODESSA, FL 33556-5414
(573) 353-0285

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
02207
MO
2251G0304X
Geriatric Physical Therapist
Primary
24312
FL

Other

Enumeration date
03/26/2007
Last updated
02/06/2020
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