Provider Demographics
NPI:1285813295
Name:ARNAOUTIS, ANTONIOS (PT)
Entity type:Individual
Prefix:
First Name:ANTONIOS
Middle Name:
Last Name:ARNAOUTIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 S BEACH ST
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-4408
Mailing Address - Country:US
Mailing Address - Phone:386-252-2400
Mailing Address - Fax:386-252-2414
Practice Address - Street 1:160 S BEACH ST
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4408
Practice Address - Country:US
Practice Address - Phone:386-252-2400
Practice Address - Fax:386-252-2414
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT13031225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAH698ZMedicare PIN