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General NPI Number Information
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NPI Number | 1285846758
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Entity Type | Individual
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Provider Name | DANA DELENE GUALTIERI PTA
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 27835 PLEASURE RIDE LOOP
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-8142
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Country | US
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Telephone | 727-415-9511
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Fax |
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Provider Business Mailing Address
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Address Line | 7770 NW 79TH AVE APT E2
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City | TAMARAC
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State | FL
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Zip | 33321-2899
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Country | US
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Telephone | 727-415-9511
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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 | 19080
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License Number State | FL
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