Provider Demographics
NPI:1487891677
Name:BATTILLO, ELISE SARA (PT)
Entity type:Individual
Prefix:MRS
First Name:ELISE
Middle Name:SARA
Last Name:BATTILLO
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 1:1184 CYPRESS LOFT PL
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4449
Mailing Address - Country:US
Mailing Address - Phone:407-804-9803
Mailing Address - Fax:407-574-5544
Practice Address - Street 1:1184 CYPRESS LOFT PL
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4449
Practice Address - Country:US
Practice Address - Phone:407-804-9803
Practice Address - Fax:407-574-5544
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-10
Last Update Date:2009-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7397225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist