Provider Demographics
NPI:1922382217
Name:JASPER, AMIE MARIE FLORES (DPT, GCS, NCS)
Entity Type:Individual
Prefix:
First Name:AMIE MARIE
Middle Name:FLORES
Last Name:JASPER
Suffix:
Gender:F
Credentials:DPT, GCS, NCS
Other - Prefix:
Other - First Name:AMIE MARIE
Other - Middle Name:RAMOS
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10215 WITTENBERG WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-7026
Mailing Address - Country:US
Mailing Address - Phone:305-934-4508
Mailing Address - Fax:
Practice Address - Street 1:10215 WITTENBERG WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-7026
Practice Address - Country:US
Practice Address - Phone:305-934-4508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24144225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist