MEDICARE: AMANDA VASIL

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	PT44321	FL

General Provider Information

NPI Number	:	1972452670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA VASIL

Provider Business Mailing Address
First Line	:	28 MYLOD ST
Second Line	:
City	:	WALPOLE
State	:	MA
Zip	:	02081-4026
Country	:	US
Telephone Number	:	617-999-5750
Fax Number	:	617-999-5750

Provider Business Practice Location Address
First Line	:	6900 DANIELS PKWY STE 36
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-1587
Country	:	US
Telephone Number	:	239-936-4404
Fax Number	:

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

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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Directions to “ AMANDA VASIL ” Practice Location

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