Provider Demographics
NPI:1720471527
Name:REID, NGOZIKA FAITH (LMT)
Entity Type:Individual
Prefix:
First Name:NGOZIKA
Middle Name:FAITH
Last Name:REID
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT #86212
Mailing Address - Street 1:2460 GRAND CENTRAL PKWY
Mailing Address - Street 2:#14
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-5052
Mailing Address - Country:US
Mailing Address - Phone:407-202-7705
Mailing Address - Fax:
Practice Address - Street 1:2460 GRAND CENTRAL PKWY
Practice Address - Street 2:#14
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-5052
Practice Address - Country:US
Practice Address - Phone:407-202-7705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14334224Z00000X
FL86212225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant