Provider Demographics
NPI:1205212982
Name:GHAISARNIA, AMEER (DPT)
Entity Type:Individual
Prefix:
First Name:AMEER
Middle Name:
Last Name:GHAISARNIA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13020 N TELECOM PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0925
Mailing Address - Country:US
Mailing Address - Phone:813-978-9700
Mailing Address - Fax:813-558-6494
Practice Address - Street 1:430 MORTON PLANT ST STE 206
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3396
Practice Address - Country:US
Practice Address - Phone:727-298-5230
Practice Address - Fax:727-298-5205
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT38195225100000X
MO2015033719225100000X
KST-04336225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist