Provider Demographics
NPI:1487701090
Name:RZEPKOWSKI, TERRY L (PT)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:RZEPKOWSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 LAKE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-5745
Mailing Address - Country:US
Mailing Address - Phone:813-944-9572
Mailing Address - Fax:
Practice Address - Street 1:3127 US HIGHWAY 98 N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-2103
Practice Address - Country:US
Practice Address - Phone:863-665-8881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY77522251X0800X
FLPT23728225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010007752OtherBCBS PROVIDER NUMBER