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NPI Code Detail

MEDICARE: VICTORIA L PERRY PTA

MEDICARE: VICTORIA L PERRY 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
1225200000XPhysical Therapy AssistantPTA32369FL

General Provider Information

NPI Number : 1447977822
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA L PERRY PTA
Provider Business Mailing Address
First Line : 4367 MAHOGANY RUN
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-2947
Country : US
Telephone Number : 863-446-3589
Fax Number :
Provider Business Practice Location Address
First Line : 520 S FLORIDA AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33801-5229
Country : US
Telephone Number : 863-268-2608
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2022
Last Update Date : 10/26/2022

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Directions to “ VICTORIA L PERRY PTA” Practice Location

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