Provider Demographics
NPI:1134890213
Name:TOTAL CARE PHYSICAL THERAPY AND WELLNESS LLC
Entity type:Organization
Organization Name:TOTAL CARE PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDERICO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:407-476-9233
Mailing Address - Street 1:14237 LAKE UNDERHILL RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-8120
Mailing Address - Country:US
Mailing Address - Phone:407-476-9233
Mailing Address - Fax:
Practice Address - Street 1:14237 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-8120
Practice Address - Country:US
Practice Address - Phone:407-923-7947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty