Provider Demographics
NPI:1215927645
Name:LE, HOANG CAM (PT)
Entity type:Individual
Prefix:MRS
First Name:HOANG
Middle Name:CAM
Last Name:LE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27553 CASHFORD CIR
Mailing Address - Street 2:STE 101
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6911
Mailing Address - Country:US
Mailing Address - Phone:813-631-9700
Mailing Address - Fax:813-631-9770
Practice Address - Street 1:27553 CASHFORD CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6974
Practice Address - Country:US
Practice Address - Phone:813-631-9700
Practice Address - Fax:813-631-9770
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 8145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL830027500Medicaid
FLY0774ZOtherBLUE CROSS BLUE SHIELD
FL830027596OtherMEDICAID WAIVER
FL830027500Medicaid