MEDICARE: SHARON HILL 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	25561	FL

General Provider Information

NPI Number	:	1801529805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON HILL PTA

Provider Business Mailing Address
First Line	:	3657 CORTEZ RD W STE 110
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-3171
Country	:	US
Telephone Number	:	941-739-7828
Fax Number	:

Provider Business Practice Location Address
First Line	:	3657 CORTEZ RD W STE 110
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-3171
Country	:	US
Telephone Number	:	941-739-7828
Fax Number	:	941-739-7838

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

Provider Enumeration Date	:	07/07/2022
Last Update Date	:	07/07/2022

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Directions to “ SHARON HILL PTA” Practice Location

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