Healthcare Provider Details

I. General information

NPI: 1043652357
Provider Name (Legal Business Name): CHRISTINA MARIA POTTER PT, ATP, SMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2013
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7821 SEMINOLE BLVD STE 1
SEMINOLE FL
33772-4825
US

IV. Provider business mailing address

7821 SEMINOLE BLVD STE 1
SEMINOLE FL
33772-4825
US

V. Phone/Fax

Practice location:
  • Phone: 305-801-8813
  • Fax:
Mailing address:
  • Phone: 305-801-8813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT22598
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: