Provider Demographics
NPI:1497268841
Name:OATES, AMBER NICHELLE (PT, DPT, OCS, CSCS)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NICHELLE
Last Name:OATES
Suffix:
Gender:F
Credentials:PT, DPT, OCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 FUSSELL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-3800
Mailing Address - Country:US
Mailing Address - Phone:813-785-6664
Mailing Address - Fax:
Practice Address - Street 1:1332 FUSSELL HOLLOW RD
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-3800
Practice Address - Country:US
Practice Address - Phone:813-785-6664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1298731225100000X
WAPT61243773225100000X
FL389522251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist