Healthcare Provider Details

I. General information

NPI: 1225510100
Provider Name (Legal Business Name): ABBY MEARS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 CURLEW RD UNIT 102
OLDSMAR FL
34677-2629
US

IV. Provider business mailing address

3903 NORTHDALE BLVD STE 111W
TAMPA FL
33624-1853
US

V. Phone/Fax

Practice location:
  • Phone: 813-343-4840
  • Fax: 866-277-6214
Mailing address:
  • Phone: 172-747-5540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT33849
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: