Healthcare Provider Details

I. General information

NPI: 1881899938
Provider Name (Legal Business Name): GENEVIEVE DUREMDEZ FLEXICARE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 11/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 54TH DR. W. BLDG. M-101
BRADENTON FL
34210
US

IV. Provider business mailing address

3701 54TH DR W BLDG M-101
BRADENTON FL
34210-3558
US

V. Phone/Fax

Practice location:
  • Phone: 941-751-7505
  • Fax: 941-753-6961
Mailing address:
  • Phone: 941-751-7505
  • Fax: 941-753-6961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MISS GENEVIEVE DACOCO DUREMDEZ
Title or Position: OWNER
Credential:
Phone: 941-751-7505