Provider Demographics
NPI:1578871778
Name:AMERES, GEORGE K (PTA)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:K
Last Name:AMERES
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13005 COMMUNITY CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4000
Mailing Address - Country:US
Mailing Address - Phone:813-969-1818
Mailing Address - Fax:
Practice Address - Street 1:13005 COMMUNITY CAMPUS DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-4000
Practice Address - Country:US
Practice Address - Phone:813-969-1818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA18912225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant