MEDICARE: AMY TRAVNICEK PT, DPT

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	225100000X	Physical Therapist	25598	FL

General Provider Information

NPI Number	:	1588971576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY TRAVNICEK PT, DPT

Provider Business Mailing Address
First Line	:	21756 STATE ROAD 54 STE 102
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33549-2905
Country	:	US
Telephone Number	:	727-475-5540
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 W CLEVELAND ST
Second Line	:	STE 220
City	:	TAMPA
State	:	FL
Zip	:	33606-1812
Country	:	US
Telephone Number	:	813-805-8105
Fax Number	:	813-254-3055

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

Provider Enumeration Date	:	09/12/2010
Last Update Date	:	01/14/2020

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Directions to “ AMY TRAVNICEK PT, DPT” Practice Location

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