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General NPI Number Information
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NPI Number | 1093825515
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Entity Type | Individual
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Provider Name | TAMMY WEAVER
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 9500 SATELLITE BLVD STE 100
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City | ORLANDO
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State | FL
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Zip | 32837-8464
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Country | US
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Telephone | 407-859-5656
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Fax |
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Provider Business Mailing Address
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Address Line | 7019 VILLA ESTELLE DR
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City | ORLANDO
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State | FL
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Zip | 32819-5247
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Country | US
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Telephone | 904-716-4459
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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