MEDICARE: DR. CELINDA P. EVITT PT, PHD, GCS

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	PT1368	FL
2	2251G0304X	Geriatric Physical Therapist	PT1368	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y4342A	OTHER	FL	MEDICARE

General Provider Information

NPI Number	:	1700157088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CELINDA P. EVITT PT, PHD, GCS

Provider Business Mailing Address
First Line	:	6309 N 20TH ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-3522
Country	:	US
Telephone Number	:	813-931-5025
Fax Number	:	813-931-5025

Provider Business Practice Location Address
First Line	:	6309 N 20TH ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-3522
Country	:	US
Telephone Number	:	813-931-5025
Fax Number	:	813-931-5025

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

Provider Enumeration Date	:	01/19/2012
Last Update Date	:	12/07/2025

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