Provider Demographics
NPI:1255162525
Name:EUPER, HAYDEN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:HAYDEN
Middle Name:
Last Name:EUPER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 BUCKNELL DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-5720
Mailing Address - Country:US
Mailing Address - Phone:504-952-5331
Mailing Address - Fax:
Practice Address - Street 1:13465 FISHHAWK BLVD
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-3833
Practice Address - Country:US
Practice Address - Phone:813-324-8009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT42167225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty