Individual
AMANDA GENELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4203 SE FEDERAL HWY STE 102, STUART, FL 34997-4925
(772) 223-3440
Mailing address
10577 165TH RD N, JUPITER, FL 33478-6222
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
22969
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22969
STATE OF FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
04/02/2012
Last updated
04/02/2012
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