Provider Demographics
NPI:1245773068
Name:DAMANA PHYSICAL THERAPY CENTER, P.A
Entity Type:Organization
Organization Name:DAMANA PHYSICAL THERAPY CENTER, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LALLA IHSSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOUHAMI EL OUAZZANI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:407-580-4226
Mailing Address - Street 1:220 ALAFAYA WOODS BLVD
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6212
Mailing Address - Country:US
Mailing Address - Phone:407-580-4226
Mailing Address - Fax:
Practice Address - Street 1:220 ALAFAYA WOODS BLVD
Practice Address - Street 2:SUITE 1002
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6212
Practice Address - Country:US
Practice Address - Phone:407-580-4226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31929225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty