Provider Demographics
NPI:1558510065
Name:PELTZ, SARAH A (PTA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:PELTZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:DEMKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:128 HAMMOCKS DR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-2073
Mailing Address - Country:US
Mailing Address - Phone:561-846-2507
Mailing Address - Fax:
Practice Address - Street 1:128 HAMMOCKS DR
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413-2073
Practice Address - Country:US
Practice Address - Phone:561-846-2507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL252Y00000X
FLPTA20983225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No252Y00000XAgenciesEarly Intervention Provider Agency