Provider Demographics
NPI:1083198543
Name:ANDINO, ARON ALBERTO (PTA)
Entity Type:Individual
Prefix:MR
First Name:ARON
Middle Name:ALBERTO
Last Name:ANDINO
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 DIOR RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-1908
Mailing Address - Country:US
Mailing Address - Phone:561-699-4279
Mailing Address - Fax:
Practice Address - Street 1:7210 BEACON WOODS DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-1974
Practice Address - Country:US
Practice Address - Phone:727-863-1521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28663225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant