Provider Demographics
NPI:1578199105
Name:MORATA, ANTONY (DPT, PT)
Entity type:Individual
Prefix:
First Name:ANTONY
Middle Name:
Last Name:MORATA
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E 2ND AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-1718
Mailing Address - Country:US
Mailing Address - Phone:407-823-8550
Mailing Address - Fax:407-823-8545
Practice Address - Street 1:5540 E GRANT ST STE C
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1668
Practice Address - Country:US
Practice Address - Phone:407-823-8550
Practice Address - Fax:407-823-8545
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
FLPT42501225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other