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General NPI Number Information
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NPI Number | 1811034523
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Entity Type | Individual
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Provider Name | MATTHEW ST. AIMEE PT
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 9555 SW 175TH TER STE 233
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City | PALMETTO BAY
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State | FL
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Zip | 33157-5604
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Country | US
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Telephone | 786-581-8889
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Fax | 786-581-8894
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Provider Business Mailing Address
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Address Line | 2209 SE 25TH AVE
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City | HOMESTEAD
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State | FL
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Zip | 33035-1354
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Country | US
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Telephone | 786-247-4630
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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 | PT18168
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT18168
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License Number State | FL
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