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General NPI Number Information
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NPI Number | 1992681191
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Entity Type | Individual
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Provider Name | AMANDA ROSE SUDLER PTA
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Gender | Female
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 7491 N FEDERAL HWY STE C16-17
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City | BOCA RATON
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State | FL
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Zip | 33487-1625
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Country | US
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Telephone | 561-450-6487
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Fax |
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Provider Business Mailing Address
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Address Line | 891 NW 85TH TER APT 1501
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City | PLANTATION
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State | FL
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Zip | 33324-1253
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Country | US
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Telephone | 954-218-6494
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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 | PTA34233
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License Number State | FL
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