Provider Demographics
NPI:1720730211
Name:STELOGEANNIS, AIMEE TROVILLO (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:TROVILLO
Last Name:STELOGEANNIS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3190 SE 45TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-8483
Mailing Address - Country:US
Mailing Address - Phone:352-816-1137
Mailing Address - Fax:
Practice Address - Street 1:12120 COUNTY ROAD 103
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:FL
Practice Address - Zip Code:34484-2987
Practice Address - Country:US
Practice Address - Phone:352-533-5884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA12532225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant