Provider Demographics
NPI:1790326817
Name:DEHLINGER, PAULA (PTA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:DEHLINGER
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 1:9414 CRESCENT LOOP CIR APT 102
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-7618
Mailing Address - Country:US
Mailing Address - Phone:585-261-4011
Mailing Address - Fax:
Practice Address - Street 1:9414 CRESCENT LOOP CIR APT 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-7618
Practice Address - Country:US
Practice Address - Phone:585-261-4011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA29470225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant