Healthcare Provider Details

I. General information

NPI: 1972215861
Provider Name (Legal Business Name): CORRINE TENARO PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 66TH ST N
ST PETERSBURG FL
33710-6200
US

IV. Provider business mailing address

1954 ALLARD DR
CLEARWATER FL
33763-2204
US

V. Phone/Fax

Practice location:
  • Phone: 800-693-5404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA26425
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: