Provider Demographics
NPI:1124638630
Name:RAMIREZ, AMY STAGLIANO (PT, DPT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:STAGLIANO
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4830 NW 43RD ST APT A8
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4402
Mailing Address - Country:US
Mailing Address - Phone:904-327-4341
Mailing Address - Fax:
Practice Address - Street 1:1203 NW 16TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4674
Practice Address - Country:US
Practice Address - Phone:352-373-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012419225100000X
FLPT29322225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist