Provider Demographics
NPI:1104458611
Name:LONSDALE, BOBBIE M (DPT)
Entity type:Individual
Prefix:
First Name:BOBBIE
Middle Name:M
Last Name:LONSDALE
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3252 INDIAN GULF LN
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34607-3720
Mailing Address - Country:US
Mailing Address - Phone:352-263-3636
Mailing Address - Fax:
Practice Address - Street 1:11463 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-7367
Practice Address - Country:US
Practice Address - Phone:352-592-1114
Practice Address - Fax:352-592-1190
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT26608225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist