Provider Demographics
NPI:1285902262
Name:FERREIRA, JUDY ANN (PTA)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:ANN
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5041 SUNRIDGE PALMS DR APT 101
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1553
Mailing Address - Country:US
Mailing Address - Phone:813-399-4816
Mailing Address - Fax:
Practice Address - Street 1:5041 SUNRIDGE PALMS DR APT 101
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-1553
Practice Address - Country:US
Practice Address - Phone:813-399-4816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1480225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant