MEDICARE: CHRISTINA DUNNE 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	PTA01367	FL

General Provider Information

NPI Number	:	1609254168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA DUNNE PTA

Provider Business Mailing Address
First Line	:	4300 W CYPRESS ST STE 401
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-4145
Country	:	US
Telephone Number	:	813-990-8880
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 W CYPRESS ST STE 401
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-4145
Country	:	US
Telephone Number	:	813-990-8880
Fax Number	:

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

Provider Enumeration Date	:	05/15/2015
Last Update Date	:	05/15/2015

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