Provider Demographics
NPI:1336941913
Name:THESONSLIGHT
Entity type:Organization
Organization Name:THESONSLIGHT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MENA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MANSOUR
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:352-459-1361
Mailing Address - Street 1:2915 LAKEVIEW DR STE 1081
Mailing Address - Street 2:
Mailing Address - City:FERN PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32730-2056
Mailing Address - Country:US
Mailing Address - Phone:407-850-8489
Mailing Address - Fax:
Practice Address - Street 1:2915 LAKEVIEW DR STE 1081
Practice Address - Street 2:
Practice Address - City:FERN PARK
Practice Address - State:FL
Practice Address - Zip Code:32730-2056
Practice Address - Country:US
Practice Address - Phone:407-850-8489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy