Provider Demographics
NPI:1225435977
Name:AHLUWALIA, AMANDEEP KAUR (PT)
Entity Type:Individual
Prefix:
First Name:AMANDEEP
Middle Name:KAUR
Last Name:AHLUWALIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13720 N CLEVELAND AVE
Mailing Address - Street 2:SUITE B, NORTH FORT MYERS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-4300
Mailing Address - Country:US
Mailing Address - Phone:239-997-8100
Mailing Address - Fax:239-997-4817
Practice Address - Street 1:13720 N CLEVELAND AVE STE B
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-4300
Practice Address - Country:US
Practice Address - Phone:239-997-8100
Practice Address - Fax:239-997-4817
Is Sole Proprietor?:No
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT29433225100000X
TX1251238225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist