LEGENDARY PHYSICAL THERAPY LLC (NPI# 1578089983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578089983 |
| Entity Type | Organization |
| Organization Name | LEGENDARY PHYSICAL THERAPY LLC |
| Other Organization Name | LEGENDARY PHYSICAL THERAPY AND WELLNESS CENTER |
| Practice Address |
4469 Mobile Hwy Ste C Pensacola FL 32506-7100 |
| Mailing Address |
2059 Juno Cir Pensacola FL 32526-8422 |
| Practice Telephone | 8502914523 |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2017-08-17 |
| Authorized Official Name | DR. LOUIE WATKINS III (PHYSICAL THERAPIST) |
| Authorized Official Telephone | 8503804377 |
| Authorized Official Credential | PT, DPT, COMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | LOUIE WATKINS III NPI NUMBER | 1568589588 | 01 |
| Other Name | Type Code |
|---|---|
| Legendary Physical Therapy and Wellness Center | Doing Business As Name - Organization |
| Street Address |
4469 MOBILE HWY STE C |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32506-7100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225215916 | Elawnto Reggie Williams | Physical Therapy Assistant | 4469 Mobile Hwy Ste C, Pensacola, FL 32506-7100 | 2008-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093332942 | Abigail Irene Dudek | Behavior Technician | 6800 West Us-98, Pensacola, FL 32506 | 2020-06-26 |
| 1053957274 | Melissa Marie Swango | Technician | 3 Usher Cir, Pensacola, FL 32506 | 2019-11-22 |
| 1215479506 | Kerry Jo Pham | Advanced Practice Midwife | 225 N New Warrington Rd, Pensacola, FL 32506 | 2016-11-17 |
| 1750761375 | Congleton Eye Care, LLC | Optometrist | 4600 Mobile Hwy, Suite 122, Pensacola, FL 32506 | 2015-06-09 |
| 1033312293 | Rogelio Tridanio Martinez Sr. | Pain Medicine | 4806 Mobile Highway, Suite D, Pensacola, FL 32506 | 2007-06-06 |
| 1215023726 | Martha Goff | Pharmacist | 50 S. Blue Angel Parkway, Pensacola, FL 32506 | 2006-10-04 |
| 1881703635 | John Daniel Hodge | Dentist | 4800 W Fairfield Dr, Pensacola, FL 32506 | 2006-08-29 |
| 1417066275 | Fairfield Dental Center | Dentist | 4800 W. Fairfield Drive, Pensacola, FL 32506 | 2006-08-29 |
| 1942277793 | Phillip Martine Drlicka | Dentist | 901 N Warrington Rd, Pensocola, FL 32506 | 2006-03-01 |
| 1083694186 | Lester Shawn Bowling | Internal Medicine | 321 South Fairfield Dr, Pensacola, FL 32506 | 2006-01-17 |
| Find all providers in zip 32506 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730183153 | Gulf Breeze Physical Therapy Inc. | Clinic/Center | 2065 Airport Blvd, Suite 300, Pensacola, FL 32504-5931 | 2005-06-13 |
| 1760092910 | Inher Physique LLC | Clinic/Center | 1108 Airport Blvd Ste C, Pensacola, FL 32504-8623 | 2020-08-03 |
| 1891319927 | Stark Performance Physical Therapy | Clinic/Center | 375 N 9th Ave Ste B, Pensacola, FL 32502-4905 | 2020-06-04 |
| 1427429604 | Physiofix LLC | Clinic/Center | 3355 Copter Rd Bldg 1&2, Pensacola, FL 32514-7083 | 2015-10-13 |
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| 1578162780 | Fourth Trimester Wellness LLC | Clinic/Center | 711 Chancellar Dr, Lutz, FL 33548-4512 | 2020-10-19 |
| 1306445754 | Concierge Rehab Inc | Clinic/Center | 1045 E Heritage Club Cir, Delray Beach, FL 33483-3483 | 2020-10-17 |
| 1689272627 | Ucdm Services Inc | Clinic/Center | 12030 Sw 129th Ct Ste 103, Miami, FL 33186-4584 | 2020-10-12 |
| 1902404163 | Frontline Physical Therapy | Clinic/Center | 8655 Bayou Way N, Pinellas Park, FL 33782-4549 | 2020-10-11 |
| 1891393138 | Venice Physical Therapy and Sports Medicine | Clinic/Center | 1776 S Tamiami Trl, Venice, FL 34293-1602 | 2020-10-09 |
| 1750988812 | Angeles Medical Center,inc. | Clinic/Center | 8725 Nw 18th Ter Ste 403, Doral, FL 33172-2610 | 2020-10-02 |
| 1740887967 | Neuro Thrive LLC | Clinic/Center | 1963 Ne Felicita Pl, Jensen Beach, FL 34957-5756 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.