Provider Demographics
NPI:1417933227
Name:NAIL, ELSA K (PT)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:K
Last Name:NAIL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ELSA
Other - Middle Name:K
Other - Last Name:NAIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3021 LAKELAND HIGHLANDS RD
Mailing Address - Street 2:COMMUNITY REHAB AND WELLNESS
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4339
Mailing Address - Country:US
Mailing Address - Phone:863-688-5232
Mailing Address - Fax:863-688-4153
Practice Address - Street 1:3021 LAKELAND HIGHLANDS RD
Practice Address - Street 2:COMMUNITY REHAB AND WELLNESS
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4339
Practice Address - Country:US
Practice Address - Phone:863-688-5232
Practice Address - Fax:863-688-4153
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT796225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY9140YMedicare ID - Type Unspecified
FL686611Medicare ID - Type UnspecifiedCRW-FACILITY