Provider Demographics
NPI:1386194009
Name:TOUHAMI EL OUAZZANI, LALLA IHSSAN
Entity Type:Individual
Prefix:
First Name:LALLA IHSSAN
Middle Name:
Last Name:TOUHAMI EL OUAZZANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 LAKE PICKETT RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4949
Mailing Address - Country:US
Mailing Address - Phone:407-580-4226
Mailing Address - Fax:
Practice Address - Street 1:2117 LAKE PICKETT RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4949
Practice Address - Country:US
Practice Address - Phone:407-580-4226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2017-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31929225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist