Healthcare Provider Details

I. General information

NPI: 1164548467
Provider Name (Legal Business Name): AMY L BIEDERMAN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23315 BLUE WATER CIR
BOCA RATON FL
33433-7053
US

IV. Provider business mailing address

10352 LIMA ST
HOLLYWOOD FL
33026-4553
US

V. Phone/Fax

Practice location:
  • Phone: 561-368-1033
  • Fax: 561-955-9640
Mailing address:
  • Phone: 954-450-1498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA729
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: