Active NPI
Renee A M Lutz, RPT, CST
- Physical Therapist
- Orlando, FL
National Provider Identifier
1760651467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 7202
- Practice address
- 11047 Fairhaven Way
Orlando, FL 32825-7111 - Phone
- (407) 275-7155
- NPI assigned
- Feb 27, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 7202 | FL | Primary |
Addresses
Primary practice location
11047 Fairhaven Way
Orlando, FL 32825-7111
Mailing address
11047 Fairhaven Way
Orlando, FL 32825-7111
Phone (407) 275-7155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT 7202 | Other | FL | DEPARTMENT OF HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 7202 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204070400000",
"number": "1760651467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11047 FAIRHAVEN WAY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328257111",
"telephone_number": "407-275-7155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11047 FAIRHAVEN WAY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328257111",
"telephone_number": "407-275-7155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTZ",
"first_name": "RENEE",
"middle_name": "A M",
"name_prefix": "Mrs.",
"credential": "RPT, CST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-27",
"last_updated": "2008-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 7202",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF HEALTH",
"identifier": "PT 7202",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.