Provider Demographics
NPI:1447394473
Name:LUMAPAS, FABIAN (PT)
Entity Type:Individual
Prefix:
First Name:FABIAN
Middle Name:
Last Name:LUMAPAS
Suffix:
Gender:M
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:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34460-0252
Mailing Address - Country:US
Mailing Address - Phone:352-220-2653
Mailing Address - Fax:352-527-4465
Practice Address - Street 1:808 US HIGHWAY 41 S
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34450-6859
Practice Address - Country:US
Practice Address - Phone:352-527-9939
Practice Address - Fax:352-527-4465
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7073225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0599Medicare ID - Type UnspecifiedMEDICARE NUMBER