Basic Information
| Provider Information | |||||||||
| NPI: | 1306335559 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | TAMMY | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PTA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ADAMS | ||||||||
| OtherFirstName: | TAMMY | ||||||||
| OtherMiddleName: | MOODY | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PTA | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | FLORIDA LIVING NURSING CENTER | ||||||||
| Address2: | 3355 EAST SEMORAN BLVD | ||||||||
| City: | APOPKA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078626263 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | FLORIDA LIVING REHAB CENTER | ||||||||
| Address2: | 3355 EAST SEMORAN BLVD | ||||||||
| City: | APOPKA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078626263 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2018 | ||||||||
| LastUpdateDate: | 05/03/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | PTA1697 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.