MEDICARE: AUTUMN ORVILLE 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	PTA31350	FL

General Provider Information

NPI Number	:	1588330625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUTUMN ORVILLE PTA

Provider Business Mailing Address
First Line	:	28712 REVARO LN
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-7618
Country	:	US
Telephone Number	:	941-962-4190
Fax Number	:

Provider Business Practice Location Address
First Line	:	4411 N HABANA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7211
Country	:	US
Telephone Number	:	813-872-2771
Fax Number	:

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

Provider Enumeration Date	:	08/18/2021
Last Update Date	:	08/18/2021

Similar Medicare Providers

1255335857 — FI-TAMPA, LLC
Practice Location Address:

4411 N HABANA AVE
TAMPA, FL
33614-7211

Practice Phone: 813-872-2771
Practice Fax: 813-871-2831

1881642650 — DR. MITCHELL DAVID CHECKVER D.O.
Practice Location Address:

7211 N DALE MABRY HWY , SUITE 100
TAMPA, FL
33614-2669

Practice Phone: 813-933-2841
Practice Fax: 813-915-0326

1245335645 — CENTRAL WEST THERAPY & REHAB INC.
Practice Location Address:

7211 N DALE MABRY HWY , SUITE 215-216
TAMPA, FL
33614-2669

Practice Phone: 813-931-0908
Practice Fax: 813-931-8483

1841435914 — HUDSON DRUGS LLC
Practice Location Address:

7211 N DALE MABRY HWY STE 101
TAMPA, FL
33614-2669

Practice Phone: 813-961-5790
Practice Fax:

1831408954 — MITCHELL CHECKVER DO PA
Practice Location Address:

7211 N DALE MABRY HWY , SUITE 100
TAMPA, FL
33614-2669

Practice Phone: 813-933-2841
Practice Fax: 813-915-0326

1942504568 — MCCLAIN, INCORPORATED
Practice Location Address:

7211 N DALE MABRY HWY , STE.#210
TAMPA, FL
33614-2669

Practice Phone: 813-930-0088
Practice Fax: 813-930-9933

1265863690 — MR. STEPHEN DANIEL KOWALSKI DPT
Practice Location Address:

4411 N HABANA AVE
TAMPA, FL
33614-7211

Practice Phone: 813-872-2771
Practice Fax:

Directions to “ AUTUMN ORVILLE PTA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.