Provider Demographics
NPI:1720197395
Name:STURM, ANNEGIEN MARIA (PT)
Entity Type:Individual
Prefix:
First Name:ANNEGIEN
Middle Name:MARIA
Last Name:STURM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 78TH AVE N
Mailing Address - Street 2:APT 237
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4418
Mailing Address - Country:US
Mailing Address - Phone:813-817-9382
Mailing Address - Fax:
Practice Address - Street 1:4800 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-3817
Practice Address - Country:US
Practice Address - Phone:727-528-1133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT13288OtherLICENSE #