Provider Demographics
NPI:1710607759
Name:ORLANDO PEDIATRIC TRAINING CENTER LLC,
Entity Type:Organization
Organization Name:ORLANDO PEDIATRIC TRAINING CENTER LLC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PRZEMYSLAW
Authorized Official - Middle Name:M
Authorized Official - Last Name:TOKARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-977-9677
Mailing Address - Street 1:PO BOX 471086
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-9086
Mailing Address - Country:US
Mailing Address - Phone:248-977-9677
Mailing Address - Fax:
Practice Address - Street 1:2501 OLD VINELAND RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-5839
Practice Address - Country:US
Practice Address - Phone:248-977-9677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy