Provider Demographics
NPI:1801000716
Name:AMIN, STUTEE R (DPT)
Entity Type:Individual
Prefix:DR
First Name:STUTEE
Middle Name:R
Last Name:AMIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 JOSHBURY CIR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39443-5801
Mailing Address - Country:US
Mailing Address - Phone:601-425-2951
Mailing Address - Fax:
Practice Address - Street 1:4566 ORANGE BLVD
Practice Address - Street 2:SUITE 1000
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9104
Practice Address - Country:US
Practice Address - Phone:877-896-3660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT3793225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist