Provider Demographics
NPI:1093953606
Name:SPANGLER, ARMANDA ODETTE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ARMANDA
Middle Name:ODETTE
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:ARMANDA
Other - Middle Name:ODETTE
Other - Last Name:SPANGLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:4325 NE 2ND CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34479-1978
Mailing Address - Country:US
Mailing Address - Phone:352-732-6773
Mailing Address - Fax:888-758-9645
Practice Address - Street 1:303 SE 17TH ST
Practice Address - Street 2:#309-217
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4421
Practice Address - Country:US
Practice Address - Phone:352-693-3378
Practice Address - Fax:888-758-9645
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA21571225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106898OtherMEDICARE ID