Provider Demographics
NPI:1598809931
Name:HUGHES, TEAMUS LEE (LPTA)
Entity Type:Individual
Prefix:MR
First Name:TEAMUS
Middle Name:LEE
Last Name:HUGHES
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5418 WATERS RD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-2645
Mailing Address - Country:US
Mailing Address - Phone:863-738-0195
Mailing Address - Fax:
Practice Address - Street 1:3248 LITHIA PINECREST RD
Practice Address - Street 2:SUITE 101
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33594-5682
Practice Address - Country:US
Practice Address - Phone:813-662-1366
Practice Address - Fax:813-662-1159
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA17059225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant