Provider Demographics
NPI:1851837033
Name:LEUSCHEL, KAYLA (PT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:LEUSCHEL
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 1:3318 SE 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-4205
Mailing Address - Country:US
Mailing Address - Phone:239-313-5049
Mailing Address - Fax:239-313-5712
Practice Address - Street 1:3318 SE 11TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-4205
Practice Address - Country:US
Practice Address - Phone:239-313-5049
Practice Address - Fax:239-313-5712
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT315722251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA29131438OtherDRIVER'S LICENSE NUMBER