Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | ||
N | 225100000X | Physical Therapist | 2305204603 | VA |
Y | 225100000X | Physical Therapist | PT19729 | FL |
NPI | 1063636496 |
---|---|
Provider Name | Monica Lynn Pokorsky |
First Address | Jacksonville, FL 32209-6810 |
Second Address | Jacksonville, FL 32209-6810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 06/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001185800 | (05) | FL |
4980093 | (05) | VA |
9116460 | OTHER (01) | VA |