Individual
PAUL OUIMET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
36428 WEST DR, FRUITLAND PARK, FL 34731-5411
(352) 216-2852
Mailing address
36428 WEST DR, FRUITLAND PARK, FL 34731-5411
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 20098
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 20098
LICENSE
FL
Enumeration date
04/12/2007
Last updated
07/08/2007
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