Healthcare Provider Details

I. General information

NPI: 1629252697
Provider Name (Legal Business Name): DORI FERN BARENHOLTZ P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 GLADES RD STE 106
BOCA RATON FL
33434-3958
US

IV. Provider business mailing address

9250 GLADES RD STE 106
BOCA RATON FL
33434-3958
US

V. Phone/Fax

Practice location:
  • Phone: 561-482-4300
  • Fax: 561-482-8855
Mailing address:
  • Phone: 561-482-4300
  • Fax: 561-482-8855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number12771
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: