Healthcare Provider Details

I. General information

NPI: 1720730211
Provider Name (Legal Business Name): AIMEE TROVILLO STELOGEANNIS LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12120 COUNTY ROAD 103
OXFORD FL
34484-2987
US

IV. Provider business mailing address

3190 SE 45TH ST
OCALA FL
34480-8483
US

V. Phone/Fax

Practice location:
  • Phone: 352-533-5884
  • Fax:
Mailing address:
  • Phone: 352-816-1137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA12532
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: