Provider Demographics
NPI:1184867459
Name:LEGASPI, AL DELOS SANTOS (PT)
Entity Type:Individual
Prefix:
First Name:AL
Middle Name:DELOS SANTOS
Last Name:LEGASPI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 LEXINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-9040
Mailing Address - Country:US
Mailing Address - Phone:708-655-2514
Mailing Address - Fax:
Practice Address - Street 1:155 LANDOVER PL
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4924
Practice Address - Country:US
Practice Address - Phone:407-937-1728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21905225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist