Provider Demographics
NPI:1811210743
Name:VITALE, HUYEN LU (PT)
Entity Type:Individual
Prefix:MRS
First Name:HUYEN
Middle Name:LU
Last Name:VITALE
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 1:3390 PLAYERS POINT LOOP
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-4771
Mailing Address - Country:US
Mailing Address - Phone:321-356-6460
Mailing Address - Fax:
Practice Address - Street 1:301 N HIGHWAY 27
Practice Address - Street 2:SUITE F
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2447
Practice Address - Country:US
Practice Address - Phone:352-432-3910
Practice Address - Fax:352-432-3911
Is Sole Proprietor?:No
Enumeration Date:2010-03-06
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21120225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist