Provider Demographics
NPI:1427738665
Name:CARLTON, TAMMY L (PTA)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:L
Last Name:CARLTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:L
Other - Last Name:CARLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2055 E GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-6799
Mailing Address - Country:US
Mailing Address - Phone:863-533-0578
Mailing Address - Fax:
Practice Address - Street 1:2055 E GEORGIA ST
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-6710
Practice Address - Country:US
Practice Address - Phone:863-533-0578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22695225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant