Healthcare Provider Details

I. General information

NPI: 1235860099
Provider Name (Legal Business Name): JENNIFER FINE NUCE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 06/22/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 8TH AVENUE SW #708 OUTPATIENT THERAPY DEPARTMENT
LARGO FL
33770-3377
US

IV. Provider business mailing address

1150 8TH AVENUE SW #708 OUTPATIENT THERAPY DEPARTMENT
LARGO FL
33770
US

V. Phone/Fax

Practice location:
  • Phone: 727-586-1701
  • Fax: 727-586-1694
Mailing address:
  • Phone: 727-586-1701
  • Fax: 727-586-1694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT28807
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: