Provider Demographics
NPI:1952699316
Name:ROSAL, LINDSEY MARIEBETH (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:MARIEBETH
Last Name:ROSAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:LINDSEY
Other - Middle Name:MARIEBETH
Other - Last Name:FAILING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:116 E BLOOMINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-8101
Mailing Address - Country:US
Mailing Address - Phone:813-655-3342
Mailing Address - Fax:813-413-8604
Practice Address - Street 1:116 E BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-8101
Practice Address - Country:US
Practice Address - Phone:813-655-3342
Practice Address - Fax:813-413-8604
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT26648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist