Provider Demographics
NPI:1194928978
Name:PONTI, DEBORAH ANN (LPTA)
Entity type:Individual
Prefix:MISS
First Name:DEBORAH
Middle Name:ANN
Last Name:PONTI
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8860 DORAL OAKS DR
Mailing Address - Street 2:#1021
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-6238
Mailing Address - Country:US
Mailing Address - Phone:813-914-9176
Mailing Address - Fax:
Practice Address - Street 1:16405 NORTHCROSS DR
Practice Address - Street 2:SUITE G2
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5091
Practice Address - Country:US
Practice Address - Phone:704-897-2456
Practice Address - Fax:480-393-4115
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA009057225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant