Provider Demographics
NPI:1972753416
Name:SERANI, AMANDA BETH (DPT)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:BETH
Last Name:SERANI
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 1:1890 STATE ROAD 436
Mailing Address - Street 2:SUITE 251
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2228
Mailing Address - Country:US
Mailing Address - Phone:407-657-5029
Mailing Address - Fax:407-657-6320
Practice Address - Street 1:1890 STATE ROAD 436
Practice Address - Street 2:SUITE 251
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2228
Practice Address - Country:US
Practice Address - Phone:407-657-5029
Practice Address - Fax:407-657-6320
Is Sole Proprietor?:No
Enumeration Date:2008-09-21
Last Update Date:2008-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 24074225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist