MEDICARE: AMANDA STEMBRIDGE

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	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1558630400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA STEMBRIDGE

Provider Business Mailing Address
First Line	:	12124 HIGH TECH AVE
Second Line	:	SUITE 300
City	:	ORLANDO
State	:	FL
Zip	:	32817-8373
Country	:	US
Telephone Number	:	800-774-7785
Fax Number	:	877-217-9271

Provider Business Practice Location Address
First Line	:	12124 HIGH TECH AVE
Second Line	:	SUITE 300
City	:	ORLANDO
State	:	FL
Zip	:	32817-8373
Country	:	US
Telephone Number	:	800-774-7785
Fax Number	:	877-217-9271

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

Provider Enumeration Date	:	12/22/2011
Last Update Date	:	12/22/2011

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Directions to “ AMANDA STEMBRIDGE ” Practice Location

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