Provider Demographics
NPI:1982069720
Name:PODSCHUN, LAURA (DPT)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:PODSCHUN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3543 VESTAVIA WAY
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-5862
Mailing Address - Country:US
Mailing Address - Phone:407-303-8837
Mailing Address - Fax:
Practice Address - Street 1:8701 MAITLAND SUMMIT BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-5915
Practice Address - Country:US
Practice Address - Phone:407-916-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL59242251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic