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General NPI Number Information
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NPI Number | 1659944585
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Entity Type | Individual
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Provider Name | AMANTE DANIEL DIEGO PTA
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Gender | Male
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 8200 SW 117TH AVE STE 300
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City | MIAMI
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State | FL
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Zip | 33183-4826
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Country | US
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Telephone | 786-870-5426
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 SW 116TH TER APT 304
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City | MIRAMAR
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State | FL
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Zip | 33025-7576
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Country | US
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Telephone |
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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 | PTA30055
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License Number State | FL
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