Provider Demographics
NPI:1720561079
Name:NORWOOD, JODIE M (PT)
Entity type:Individual
Prefix:MRS
First Name:JODIE
Middle Name:M
Last Name:NORWOOD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:M
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:600 NORTHERN WAY APT 610
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6312
Mailing Address - Country:US
Mailing Address - Phone:407-949-8602
Mailing Address - Fax:
Practice Address - Street 1:600 NORTHERN WAY APT 610
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-6312
Practice Address - Country:US
Practice Address - Phone:407-949-8602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19420261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy