Provider Demographics
NPI:1316695083
Name:PINKERTON, ADRIANA NESTA (PTA)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:NESTA
Last Name:PINKERTON
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 1:5483 RISHLEY RUN WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-8019
Mailing Address - Country:US
Mailing Address - Phone:407-473-3097
Mailing Address - Fax:
Practice Address - Street 1:445 WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-9518
Practice Address - Country:US
Practice Address - Phone:352-383-0051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-12
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
24138225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant