Healthcare Provider Details

I. General information

NPI: 1578497194
Provider Name (Legal Business Name): DASHLEY GONZALEZ SCIASCIA PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14155 TOWN LOOP BLVD
ORLANDO FL
32837-6185
US

IV. Provider business mailing address

22 AEGEAN AVE
AMHERST NY
14228-1662
US

V. Phone/Fax

Practice location:
  • Phone: 407-541-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA33785
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: