Provider Demographics
NPI:1275771289
Name:KESSINGER, PAULA (PTA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:KESSINGER
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 1:2725 ROBIE AVE
Mailing Address - Street 2:SUITE 2013
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-9619
Mailing Address - Country:US
Mailing Address - Phone:352-383-4446
Mailing Address - Fax:352-383-4449
Practice Address - Street 1:2725 ROBIE AVE
Practice Address - Street 2:SUITE 2013
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-9619
Practice Address - Country:US
Practice Address - Phone:352-383-4446
Practice Address - Fax:352-383-4449
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 20149225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant