Provider Demographics
NPI:1548425374
Name:TRAMA, PATRICIA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:TRAMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 PLANTATION CENTER DR
Mailing Address - Street 2:SUITE 57
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-3352
Mailing Address - Country:US
Mailing Address - Phone:904-374-1414
Mailing Address - Fax:877-736-3470
Practice Address - Street 1:2245 PLANTATION CENTER DR
Practice Address - Street 2:SUITE 57
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-3352
Practice Address - Country:US
Practice Address - Phone:904-374-1414
Practice Address - Fax:877-736-3470
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT38322251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000232500Medicaid