Provider Demographics
NPI:1417195223
Name:LYONS, EILEEN PATRICIA (PT)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:PATRICIA
Last Name:LYONS
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 1:5979 VINELAND RD
Mailing Address - Street 2:304
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7800
Mailing Address - Country:US
Mailing Address - Phone:407-354-3906
Mailing Address - Fax:407-354-3907
Practice Address - Street 1:5979 VINELAND RD
Practice Address - Street 2:304
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7800
Practice Address - Country:US
Practice Address - Phone:407-354-3906
Practice Address - Fax:407-354-3907
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist