Provider Demographics
NPI:1154687002
Name:STAPLES, TAMMY D (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:D
Last Name:STAPLES
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 KENNEDY DR
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4023
Mailing Address - Country:US
Mailing Address - Phone:305-292-5872
Mailing Address - Fax:305-292-5882
Practice Address - Street 1:1200 KENNEDY DR
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4023
Practice Address - Country:US
Practice Address - Phone:305-292-5872
Practice Address - Fax:305-292-5882
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 19542225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist