Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT33621 | FL |
NPI | 1609440692 |
---|---|
Provider Name | Dr. Jason Ray Berlongieri |
First Address | Delray Beach, FL 33446-2226 |
Second Address | Delray Beach, FL 33484-6514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2021 |
Last Update Date | 21/06/2021 |