Provider Demographics
NPI:1306409446
Name:GIRTMAN, CHARLA (LAT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:CHARLA
Middle Name:
Last Name:GIRTMAN
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 RAMBLING CIR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-3473
Mailing Address - Country:US
Mailing Address - Phone:407-257-1400
Mailing Address - Fax:
Practice Address - Street 1:259 RAMBLING CIR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-3473
Practice Address - Country:US
Practice Address - Phone:407-257-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL23612255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer