Provider Demographics
NPI:1164548467
Name:BIEDERMAN, AMY L (PTA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:BIEDERMAN
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 1:10352 LIMA ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4553
Mailing Address - Country:US
Mailing Address - Phone:954-450-1498
Mailing Address - Fax:
Practice Address - Street 1:23315 BLUE WATER CIR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7053
Practice Address - Country:US
Practice Address - Phone:561-368-1033
Practice Address - Fax:561-955-9640
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA729225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant