Healthcare Provider Details

I. General information

NPI: 1487267605
Provider Name (Legal Business Name): JONATHAN MICHAEL TURMEL SR. PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2020
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14035 IRVING ST
SPRING HILL FL
34609-8843
US

IV. Provider business mailing address

14035 IRVING ST
SPRING HILL FL
34609-8843
US

V. Phone/Fax

Practice location:
  • Phone: 352-573-3343
  • Fax:
Mailing address:
  • Phone: 352-573-3343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA30053
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: