MEDICARE: VICKI DEUTSCH PTA/L

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	PTA19792	FL

General Provider Information

NPI Number	:	1366079873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKI DEUTSCH PTA/L

Provider Business Mailing Address
First Line	:	PO BOX 120547
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34712-0547
Country	:	US
Telephone Number	:	352-394-0212
Fax Number	:	352-241-6361

Provider Business Practice Location Address
First Line	:	235 CITRUS TOWER BLVD STE 105
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-2711
Country	:	US
Telephone Number	:	321-972-4122
Fax Number	:	407-542-2168

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

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	01/01/2026

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Directions to “ VICKI DEUTSCH PTA/L” Practice Location

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