Active NPI
Eileen M. Frederick, PT
- Physical Therapist
- Apopka, FL
National Provider Identifier
1922338243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT23726
- Practice address
- 3320 State Road 436
Suite 1010
Apopka, FL 32703-6003 - Phone
- (407) 542-0899
- Fax
- (407) 956-2194
- NPI assigned
- Jan 8, 2010
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 17082 | MA | |
| Physical Therapist | 225100000X | 007438-1 | NY | |
| Physical Therapist | 225100000X | PT23726 | FL | Primary |
Addresses
Primary practice location
3320 State Road 436
Suite 1010
Apopka, FL 32703-6003
Mailing address
PO Box 1921
Winter Park, FL 32790-1921
Phone (407) 335-0125
Other names 1
- Eileen F. Leary
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 |
|---|---|---|---|
| 007438-1 | NY | MD | Specialist |
| 17082 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625702400000",
"number": "1922338243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1921",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327901921",
"telephone_number": "407-335-0125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3320 STATE ROAD 436",
"address_2": "SUITE 1010",
"city": "APOPKA",
"state": "FL",
"postal_code": "327036003",
"telephone_number": "407-542-0899",
"fax_number": "407-956-2194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "EILEEN",
"middle_name": "M.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-08",
"last_updated": "2021-07-08",
"certification_date": "2021-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "17082",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "007438-1",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT23726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EILEEN",
"last_name": "LEARY",
"middle_name": "F.",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Apopka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.