Healthcare Provider Details

I. General information

NPI: 1912812090
Provider Name (Legal Business Name): JOEY STANCOMBE PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1064 CAMBRIDGE DR
WINTER HAVEN FL
33881-9741
US

IV. Provider business mailing address

6141 LAKE WORTH RD
GREENACRES FL
33463-3074
US

V. Phone/Fax

Practice location:
  • Phone: 863-709-7576
  • Fax:
Mailing address:
  • Phone: 866-573-2556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA33354
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: