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General NPI Number Information
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NPI Number | 1386733665
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Entity Type | Individual
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Provider Name | BRIAN SAMUEL CAMMAROTA ATC
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 651 N OLD COACHMAN RD CARPENTER COMPLEX
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City | CLEARWATER
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State | FL
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Zip | 33765-2321
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Country | US
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Telephone | 727-712-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 14 ROSSITER AVE
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-2510
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Country | US
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Telephone | 610-529-9557
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT002109A
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License Number State | PA
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