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General NPI Number Information
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NPI Number | 1225320781
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Entity Type | Individual
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Provider Name | MRS. SUNITHA ACHAMMA JOB
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Gender | Female
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Dates
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Enumeration Date | 05/03/2011
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Last Update Date | 05/03/2011
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Provider Practice Location Address
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Address Line | 3201 WEST COMMERCIAL BLVD SUITE 116 MEDPRO HEALTH CARE STAFFING
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309
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Country | US
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Telephone | 800-886-8108
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Fax | 866-422-6431
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Provider Business Mailing Address
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Address Line | 3278 CORAL RIDGE DRIVE 3278
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City | CORAL SPRINGS
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State | FL
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Zip | 33065
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Country | US
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Telephone | 954-394-4464
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501014232
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 032763
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License Number State | NY
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