Provider Demographics
NPI:1982385910
Name:LENNEAR, TRUEVETTE (COTA)
Entity Type:Individual
Prefix:
First Name:TRUEVETTE
Middle Name:
Last Name:LENNEAR
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:974 COSTA MESA LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-7229
Mailing Address - Country:US
Mailing Address - Phone:321-848-8330
Mailing Address - Fax:
Practice Address - Street 1:974 COSTA MESA LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-7229
Practice Address - Country:US
Practice Address - Phone:321-848-8330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA10253208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty