Provider Demographics
NPI:1881944841
Name:HARDIE, AMANDA
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:HARDIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 FAWNWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-5948
Mailing Address - Country:US
Mailing Address - Phone:260-241-8808
Mailing Address - Fax:
Practice Address - Street 1:400 TAMIAMI TRL S
Practice Address - Street 2:210
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2614
Practice Address - Country:US
Practice Address - Phone:941-483-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 27523225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist