Active NPI
Lowell S Liwanag, RPT, WCC, CWS
- Physical Therapist
- Lake Wales, FL
National Provider Identifier
1780600155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT11021
- Practice address
- 2027 State Road 60 E
Lake Wales, FL 33898-5113 - Phone
- (863) 678-1557
- Fax
- (863) 676-2077
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- 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 | PT11021 | FL | Primary |
Addresses
Primary practice location
2027 State Road 60 E
Lake Wales, FL 33898-5113
Mailing address
PO Box 1168
Lake Wales, FL 33859-1168
Phone (863) 678-1557
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT11021 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215648000000",
"number": "1780600155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1168",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338591168",
"telephone_number": "863-678-1557",
"fax_number": "863-582-9279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2027 STATE ROAD 60 E",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338985113",
"telephone_number": "863-678-1557",
"fax_number": "863-676-2077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIWANAG",
"first_name": "LOWELL",
"middle_name": "S",
"credential": "RPT, WCC, CWS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2008-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT11021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Wales, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.