Provider Demographics
NPI:1659592087
Name:POSPISIL, ANN ALLEN (PT)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:ALLEN
Last Name:POSPISIL
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 1:210 WAVERLY DR
Mailing Address - Street 2:
Mailing Address - City:FERN PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32730-2627
Mailing Address - Country:US
Mailing Address - Phone:407-622-5150
Mailing Address - Fax:
Practice Address - Street 1:600 COURTLAND ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-1332
Practice Address - Country:US
Practice Address - Phone:407-691-8205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 4902225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist