MEDICARE: PATRICIA ANTOINETTE TORMA P.T.A.

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	PTA18636	FL
2	225200000X	Physical Therapy Assistant	160-004428	IL

General Provider Information

NPI Number	:	1912150095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ANTOINETTE TORMA P.T.A.

Provider Business Mailing Address
First Line	:	3186 BURBERRY ST
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34688-7258
Country	:	US
Telephone Number	:	727-940-4013
Fax Number	:

Provider Business Practice Location Address
First Line	:	3186 BURBERRY ST
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34688-7258
Country	:	US
Telephone Number	:	727-940-4013
Fax Number	:

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

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	01/20/2011

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