Tracy Ann Griffith, PTA

Individual provider Active NPI Physical Therapy Assistant · Heathrow, FL

NPI 1811161177 · NPPES record last updated Oct 15, 2011

Key facts

NPI
1811161177
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA 21177 (FL)
Practice address
1337 S. International Pkwy
Suite 1321
Heathrow, FL 32771-1013
Phone
(407) 833-0802
NPI assigned
Apr 17, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA 21177FLMDPhysical Therapy Assistant

Networks

  • Optimum HealthCare HMO Network

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 21177 FL Yes

Addresses

Primary practice location

1337 S. International Pkwy
Suite 1321
Heathrow, FL 32771-1013

Mailing address

1001 Pioneer Way
Geneva, FL 32732-9131
Phone (321) 217-3377

Other names

  • Tracy Ann Oates Former name

Other providers in Heathrow, FL

All providers in Heathrow, FL · Physical Therapy Assistant in Florida

Sources for this page

Verify at the official NPI Registry.