Provider Demographics
NPI:1659939981
Name:ARNETT, STEPHANIE JULIE (PTA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JULIE
Last Name:ARNETT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8810 PINE TREE DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-1668
Mailing Address - Country:US
Mailing Address - Phone:863-370-3244
Mailing Address - Fax:
Practice Address - Street 1:16 LAKE HUNTER DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-1297
Practice Address - Country:US
Practice Address - Phone:863-688-5521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-02
Last Update Date:2019-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26774225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant