Provider Demographics
NPI:1356579122
Name:LIMPRAPHANONTA, JANELLE MARIE (PT, DPT, OCS, COMT)
Entity type:Individual
Prefix:MS
First Name:JANELLE
Middle Name:MARIE
Last Name:LIMPRAPHANONTA
Suffix:
Gender:F
Credentials:PT, DPT, OCS, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:KENNETH CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33709-4827
Mailing Address - Country:US
Mailing Address - Phone:727-546-4700
Mailing Address - Fax:727-549-8108
Practice Address - Street 1:812 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5642
Practice Address - Country:US
Practice Address - Phone:727-441-4549
Practice Address - Fax:727-441-4540
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24735225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist