Provider Demographics
NPI:1780482240
Name:BALTAR, ALLISON (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BALTAR
Suffix:
Gender:
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 1:3219 HARGILL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1714
Mailing Address - Country:US
Mailing Address - Phone:407-810-3636
Mailing Address - Fax:
Practice Address - Street 1:1939 MAGUIRE RD # 107-108
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-7942
Practice Address - Country:US
Practice Address - Phone:407-473-8005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT42807225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist