Provider Demographics
NPI:1881206290
Name:BUETTNER, CINDY (LMT; PTA)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:BUETTNER
Suffix:
Gender:F
Credentials:LMT; PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 N DUNCAN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-6115
Mailing Address - Country:US
Mailing Address - Phone:785-210-4849
Mailing Address - Fax:
Practice Address - Street 1:4135 LINDEVER LN
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-9058
Practice Address - Country:US
Practice Address - Phone:785-210-4849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225700000X
FLPTA30374225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist