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NPI Code Detail

MEDICARE: JEFFREY TAYLOR PITTS PTA

MEDICARE: JEFFREY TAYLOR PITTS PTA
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
1225200000XPhysical Therapy AssistantPTA 25779FL

General Provider Information

NPI Number : 1881078335
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY TAYLOR PITTS PTA
Provider Business Mailing Address
First Line : 807 N TYNDALL PKWY
Second Line :
City : CALLAWAY
State : FL
Zip : 32404-9495
Country : US
Telephone Number : 850-215-8844
Fax Number : 850-215-6644
Provider Business Practice Location Address
First Line : 807 N TYNDALL PKWY
Second Line :
City : CALLAWAY
State : FL
Zip : 32404-9495
Country : US
Telephone Number : 850-215-8844
Fax Number : 850-215-6644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2015
Last Update Date : 07/15/2015

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Directions to “ JEFFREY TAYLOR PITTS PTA” Practice Location

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