Individual
MR. RICHARD SHOHEI LILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA, CLT
Contact information
Practice address
6000 TURKEY LAKE RD STE 203, ORLANDO, FL 32819-4206
(407) 352-3508
Mailing address
12757 NEWFIELD DR, ORLANDO, FL 32837-7435
(407) 721-2024
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
29983
FL
Other
Enumeration date
02/05/2020
Last updated
06/29/2023
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