Provider Demographics
NPI:1962734632
Name:STRICKLE, JODENE (PTA)
Entity type:Individual
Prefix:MRS
First Name:JODENE
Middle Name:
Last Name:STRICKLE
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 1:3096 JUNEBERRY TER
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-6629
Mailing Address - Country:US
Mailing Address - Phone:321-765-4644
Mailing Address - Fax:
Practice Address - Street 1:3861 OAKWATER CIR STE 1
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6258
Practice Address - Country:US
Practice Address - Phone:407-481-8861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 14267225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant