MEDICARE: AMANDA KAY GRIENER MPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT19913	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y01L2	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083751093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA KAY GRIENER MPT

Provider Business Mailing Address
First Line	:	382 TRAVINO AVE
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32086-7369
Country	:	US
Telephone Number	:	904-797-7310
Fax Number	:

Provider Business Practice Location Address
First Line	:	2630 US 1 S
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32086-6191
Country	:	US
Telephone Number	:	904-829-3411
Fax Number	:	904-829-3412

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	07/30/2025

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Directions to “ AMANDA KAY GRIENER MPT” Practice Location

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