Healthcare Provider Details

I. General information

NPI: 1679455489
Provider Name (Legal Business Name): ASHTON ABERNATHY PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 WINTER GARDEN VINELAND RD
WINTER GARDEN FL
34787-4303
US

IV. Provider business mailing address

4780 DATA CT
ORLANDO FL
32817-8331
US

V. Phone/Fax

Practice location:
  • Phone: 407-904-0135
  • Fax:
Mailing address:
  • Phone: 407-904-0135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number33701
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: