Healthcare Provider Details

I. General information

NPI: 1881206290
Provider Name (Legal Business Name): CINDY BUETTNER LMT; PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 11/07/2021
Certification Date: 11/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4135 LINDEVER LN
PALMETTO FL
34221-9058
US

IV. Provider business mailing address

116 N DUNCAN AVE
CLEARWATER FL
33755-6115
US

V. Phone/Fax

Practice location:
  • Phone: 785-210-4849
  • Fax:
Mailing address:
  • Phone: 785-210-4849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA30374
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: