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General NPI Number Information
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NPI Number | 1104233279
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Entity Type | Individual
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Provider Name | BETH AMARAL PTA
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Gender | Female
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 07/21/2014
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Provider Practice Location Address
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Address Line | 910 OLD CAMP RD STE 100
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City | THE VILLAGES
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State | FL
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Zip | 32162-5605
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Country | US
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Telephone | 352-259-6780
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Fax |
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Provider Business Mailing Address
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Address Line | 201 S MAIN AVE UNIT A
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City | MINNEOLA
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State | FL
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Zip | 34715-5542
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Country | US
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Telephone | 352-978-5525
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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 | PTA24909
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License Number State | FL
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