Luther Quitoriano Braganza, PT
Individual provider Active NPI Physical Therapist · Lady Lake, FL
NPI 1003000381 · NPPES record last updated Aug 30, 2007
Key facts
- NPI
- 1003000381
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT21044 (FL)
- Practice address
- 134 N Old Dixie Hwy
Lady Lake, FL 32159-4347 - Phone
- (352) 751-6627
- NPI assigned
- Aug 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT21044 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leesburg Rehabilitation Specialists | Physical Therapist | Past | Accepting new patients |
| FL Rehab Services LLC | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT21044 | FL | Yes |
Addresses
Primary practice location
134 N Old Dixie Hwy
Lady Lake, FL 32159-4347
Mailing address
10212 Granite CT
Leesburg, FL 34788-3130
Phone (352) 751-6627
Other providers in Lady Lake, FL
- Bladder Institute of Florida LLC
- Mica Collins Booth
- Keith L Bostaph
- Kenneth Lee Bowman
- Susan Lyn Bowman
- Dianna Bridges
- Tara Lynne Briggs
- Keri Kristin Brooks
- Jenna Elizabeth Brown
- Patricia Ann Brown
All providers in Lady Lake, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.