Provider Demographics
NPI:1760696660
Name:URSO, AMANDA (MPT)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:URSO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 TWIN RIVERS BLVD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-5106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5000 WATERDAM PLAZA DR
Practice Address - Street 2:SUITE 240
Practice Address - City:MCMURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-5412
Practice Address - Country:US
Practice Address - Phone:724-941-0111
Practice Address - Fax:724-941-9231
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018554225100000X
FLPT18731225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist