Provider Demographics
NPI:1497061824
Name:AMAT, CANDICE ESGUERRA (DPT)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:ESGUERRA
Last Name:AMAT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 KING ARTHUR CIR
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5823
Mailing Address - Country:US
Mailing Address - Phone:407-637-7621
Mailing Address - Fax:
Practice Address - Street 1:811 S ORLANDO AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-7102
Practice Address - Country:US
Practice Address - Phone:407-539-1792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24750225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist