Provider Demographics
NPI:1790713188
Name:WARD, DARLA (PT)
Entity Type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:
Last Name:WARD
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:PO BOX 136662
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34713-6662
Mailing Address - Country:US
Mailing Address - Phone:352-243-9341
Mailing Address - Fax:352-243-8293
Practice Address - Street 1:1050 US HIGHWAY 27
Practice Address - Street 2:SUITE #15
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34714-7508
Practice Address - Country:US
Practice Address - Phone:352-243-9341
Practice Address - Fax:352-243-8293
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 7393225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ35974Medicare ID - Type Unspecified