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NPI Code Detail

MEDICARE: ASHLEY EVANS P.T.

MEDICARE: ASHLEY EVANS P.T.
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
1225100000XPhysical Therapist1146872TX
2225100000XPhysical Therapist23969FL

General Provider Information

NPI Number : 1457453953
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY EVANS P.T.
Provider Business Mailing Address
First Line : 3416 S DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33629-8639
Country : US
Telephone Number : 813-837-3060
Fax Number : 813-837-3080
Provider Business Practice Location Address
First Line : 3416 S DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33629-8639
Country : US
Telephone Number : 813-837-3060
Fax Number : 813-837-3080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2006
Last Update Date : 04/23/2008

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