Provider Demographics
NPI:1407666357
Name:LEUTZ DA SILVA GODINHO, ALINE MICHELE (PT)
Entity type:Individual
Prefix:
First Name:ALINE MICHELE
Middle Name:
Last Name:LEUTZ DA SILVA GODINHO
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 1:5689 NEW INDEPENDENCE PKWY
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787
Mailing Address - Country:US
Mailing Address - Phone:407-244-0547
Mailing Address - Fax:
Practice Address - Street 1:1180 SPRING CENTRE S. BLVD
Practice Address - Street 2:STE 225
Practice Address - City:ALTMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714
Practice Address - Country:US
Practice Address - Phone:407-495-1165
Practice Address - Fax:800-688-2049
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT42627225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist