Provider Demographics
NPI: | 1003006073 |
---|---|
Name: | WEIBEL, CATHERINE ANN (MPT) |
Entity Type: | Individual |
Prefix: | MS |
First Name: | CATHERINE |
Middle Name: | ANN |
Last Name: | WEIBEL |
Suffix: | |
Gender: | F |
Credentials: | MPT |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 260 S OSCEOLA AVE |
Mailing Address - Street 2: | APT 1101 |
Mailing Address - City: | ORLANDO |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32801-2811 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 772-532-5812 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 260 S OSCEOLA AVE |
Practice Address - Street 2: | APT 1101 |
Practice Address - City: | ORLANDO |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32801-2811 |
Practice Address - Country: | US |
Practice Address - Phone: | 772-532-5812 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2007-07-26 |
Last Update Date: | 2008-12-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IL | 70014519 | 2251S0007X |
FL | 18784 | 2251X0800X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | Group - Multi-Specialty |
No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Multi-Specialty |