Provider Demographics
NPI:1598655094
Name:SKINNER, GERALDINE ANN
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:ANN
Last Name:SKINNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KANTA
Other - Middle Name:
Other - Last Name:SKINNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2463 HILLVIEW ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3034
Mailing Address - Country:US
Mailing Address - Phone:941-284-0799
Mailing Address - Fax:
Practice Address - Street 1:8400 VAMO RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-7811
Practice Address - Country:US
Practice Address - Phone:941-966-5611
Practice Address - Fax:877-489-3963
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA13025225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant