Provider Demographics
NPI:1679801682
Name:KOHLER, AMY ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:KOHLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4806 N ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-1605
Mailing Address - Country:US
Mailing Address - Phone:407-206-3326
Mailing Address - Fax:407-206-3316
Practice Address - Street 1:4806 N ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-1605
Practice Address - Country:US
Practice Address - Phone:407-206-3326
Practice Address - Fax:407-206-3316
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031046-1225100000X
FL26162225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist