Provider Demographics
NPI:1457325458
Name:LATOTZKE, ANNABELLA S (DPT, ATC, LAT, MTC)
Entity Type:Individual
Prefix:MS
First Name:ANNABELLA
Middle Name:S
Last Name:LATOTZKE
Suffix:
Gender:F
Credentials:DPT, ATC, LAT, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4984
Mailing Address - Country:US
Mailing Address - Phone:407-647-2287
Mailing Address - Fax:
Practice Address - Street 1:801 S ORLANDO AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4867
Practice Address - Country:US
Practice Address - Phone:407-691-7697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19661225100000X, 2251X0800X
FLAL19062255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer