MEDICARE: MRS. DEBORAH LYNN STOLGITIS PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PTA20855	FL

General Provider Information

NPI Number	:	1336354323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH LYNN STOLGITIS PTA

Provider Business Mailing Address
First Line	:	14081 80TH LN N
Second Line	:
City	:	LOXAHATCHEE
State	:	FL
Zip	:	33470-4320
Country	:	US
Telephone Number	:	561-793-4575
Fax Number	:

Provider Business Practice Location Address
First Line	:	1191 E NEWPORT CENTER DR
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-7715
Country	:	US
Telephone Number	:	954-421-8361
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	07/08/2007

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