Provider Demographics
NPI:1528253150
Name:BOND, SANDRA LYNN
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:LYNN
Last Name:BOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 79TH ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-1042
Mailing Address - Country:US
Mailing Address - Phone:727-204-8174
Mailing Address - Fax:
Practice Address - Street 1:5101 BRITTANY DR S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33715-1565
Practice Address - Country:US
Practice Address - Phone:727-865-8959
Practice Address - Fax:727-865-8957
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7764225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist