Provider Demographics
NPI:1396207908
Name:NEEMA, PRIYA (PT)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:NEEMA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13237 HEATHER MOSS DR APT 1003
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-5541
Mailing Address - Country:US
Mailing Address - Phone:913-360-9810
Mailing Address - Fax:
Practice Address - Street 1:8010 SUNPORT DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-8112
Practice Address - Country:US
Practice Address - Phone:407-851-0883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0003811225100000X
FLPT34494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist