Provider Demographics
NPI:1457491151
Name:ENGELBERG, STEPHANIE (PT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ENGELBERG
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 1:265 ROLLINGWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3412
Mailing Address - Country:US
Mailing Address - Phone:407-774-4314
Mailing Address - Fax:407-246-0135
Practice Address - Street 1:1301 SLIGH BLVD
Practice Address - Street 2:1301 SLIGH BLVD
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3901
Practice Address - Country:US
Practice Address - Phone:407-649-6888
Practice Address - Fax:407-246-0135
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 00010482251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic