Provider Demographics
NPI:1336928852
Name:FLEMING, AMANDA SMITH (DPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:SMITH
Last Name:FLEMING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LAINE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 N ALAFAYA TRL STE 900
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4737
Mailing Address - Country:US
Mailing Address - Phone:407-514-3657
Mailing Address - Fax:407-381-1971
Practice Address - Street 1:1900 N ALAFAYA TRL STE 900
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4737
Practice Address - Country:US
Practice Address - Phone:407-514-3657
Practice Address - Fax:407-381-1971
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT40752225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist