LEGACY HEALHCARE SERVICES, INC. (NPI# 1528501178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528501178 |
| Entity Type | Organization |
| Organization Name | LEGACY HEALHCARE SERVICES, INC. |
| Practice Address |
3050 Woodmont Ave Winter Haven FL 33884-3800 |
| Practice Telephone | 8638756584 |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |
| Authorized Official Name | ROSE CARTER (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 9193279674 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PT 04827 | FL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912505322 | Legacy Healhcare Services, Inc. | Occupational Therapist | 42400 W 12 Mile Rd, Novi, MI 48377-3027 | 2020-10-16 |
| 1235770967 | Legacy Healhcare Services, Inc. | Occupational Therapist | 10300 Three Chopt Rd Apt 222, Henrico, VA 23233-2072 | 2019-10-03 |
| 1912505488 | Legacy Healhcare Services, Inc. | Occupational Therapist | 2220 Executive Dr, Hampton, VA 23666-6607 | 2020-10-15 |
| Street Address |
3050 WOODMONT AVE |
| City | WINTER HAVEN |
| State | FL |
| Zip Code | 33884-3800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528373669 | Jennifer L Nesbit | Speech-Language Pathologist | 3050 Woodmont Ave, Winter Haven, FL 33884-3800 | 2010-08-12 |
| 1740825165 | Stephanie Taylor Treadwell | Occupational Therapist | 3050 Woodmont Ave, Winter Haven, FL 33884-3800 | 2019-11-08 |
| 1962058008 | Jade Johnson | Physical Therapy Assistant | 3050 Woodmont Ave, Winter Haven, FL 33884-3800 | 2019-08-14 |
| 1235644022 | Grace Marie Banquicio | Occupational Therapy Assistant | 3050 Woodmont Ave, Winter Haven, FL 33884-3800 | 2017-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154956480 | Kristin Helen Kiddy | Occupational Therapy Assistant | 101 Overlook Drive, Suite 103, Winter Haven, FL 33884 | 2020-03-06 |
| 1871990143 | William Santo | Specialist/Technologist | 9269 Kliber Dr., Winter Haven, FL 33884 | 2014-12-02 |
| 1346656345 | Integrative Physical Medicine of Winter Haven LLC | Specialist | 7494 Cypress Gardens Blvd, Winter Haven, FL 33884 | 2014-07-10 |
| 1568808921 | Donald Lurton Arey Jr. | Surgery | 800 Island Way, Winter Haven, FL 33884 | 2013-05-13 |
| 1407195324 | Shena R. Ranon | Nurse Practitioner | 1820 Woodpointe Dr, Winter Haven, FL 33884 | 2013-02-13 |
| 1952654543 | Mpn Medical Center of Dundee | Family Medicine | 1023 Dundee Road, Winter Haven, FL 33884 | 2012-10-19 |
| 1588941736 | Cody Gernatt | Occupational Therapist | 1120 Cypress Gardens Blvd., Winter Haven, FL 33884 | 2011-11-15 |
| 1851611677 | Paulene T Jasurek | Pharmacist | 4454 Cypress Gardens Rd, Winter Haven, FL 33884 | 2010-06-03 |
| 1306169867 | John David Butters | Speech-Language Pathologist | 208 Escambia Dr., Winter Haven, FL 33884 | 2010-03-11 |
| 1710162813 | Humphrey Chiropractic Center, P.a. | Chiropractor | 605 Overlook Drive, Suite 1, Winter Haven, FL 33884 | 2008-01-08 |
| Find all providers in zip 33884 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144755844 | Marjorie Lucas | Clinic/Center | 219 Terranova Blvd, Winter Haven, FL 33884-3423 | 2017-05-01 |
| 1689117970 | Bryan Linares | Clinic/Center | 410 Red Hawk Loop, Winter Haven, FL 33880-4975 | 2016-11-18 |
| 1518416189 | Patricia Rucki | Clinic/Center | 3409 Cove Ct W, Winter Haven, FL 33880-5062 | 2016-09-23 |
| 1598819401 | Sports and Orthopedic Rehabilitation Services Inc | Clinic/Center | 1499 6th St Nw, Winter Haven, FL 33881-2365 | 2007-01-22 |
| 1457720260 | Tracy Peck | Clinic/Center | 1601 6th St Se, Suite B, Winter Haven, FL 33880-4605 | 2015-09-22 |
| 1093184269 | Cora Rehabilitation | Clinic/Center | 1601 6th St Se, Suite B, Winter Haven, FL 33880-4605 | 2015-09-17 |
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|---|---|---|---|---|
| 1356942742 | Restore Pelvic Health & Rehab LLC | Clinic/Center | 301 E Yamato Rd Ste 1240, Boca Raton, FL 33431-4931 | 2020-11-03 |
| 1558962019 | Ldg Medical Center LLC | Clinic/Center | 4485 Stirling Rd, Davie, FL 33314-7517 | 2020-11-02 |
| 1255930855 | Tideline Sports Performance & Rehabilitation LLC | Clinic/Center | 5261 Paylor Ln, Lakewood Ranch, FL 34240-2203 | 2020-10-23 |
| 1578162780 | Fourth Trimester Wellness LLC | Clinic/Center | 711 Chancellar Dr, Lutz, FL 33548-4512 | 2020-10-19 |
| 1306445754 | Concierge Rehab Inc | Clinic/Center | 1045 E Heritage Club Cir, Delray Beach, FL 33483-3483 | 2020-10-17 |
| 1689272627 | Ucdm Services Inc | Clinic/Center | 12030 Sw 129th Ct Ste 103, Miami, FL 33186-4584 | 2020-10-12 |
| 1902404163 | Frontline Physical Therapy | Clinic/Center | 8655 Bayou Way N, Pinellas Park, FL 33782-4549 | 2020-10-11 |
| 1891393138 | Venice Physical Therapy and Sports Medicine | Clinic/Center | 1776 S Tamiami Trl, Venice, FL 34293-1602 | 2020-10-09 |
| 1750988812 | Angeles Medical Center,inc. | Clinic/Center | 8725 Nw 18th Ter Ste 403, Doral, FL 33172-2610 | 2020-10-02 |
| 1740887967 | Neuro Thrive LLC | Clinic/Center | 1963 Ne Felicita Pl, Jensen Beach, FL 34957-5756 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | WINTER HAVEN |
| Zip Code | 33884 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.