Healthcare Provider Details

I. General information

NPI: 1356822233
Provider Name (Legal Business Name): LAURENCE JOSEPH PIRETRA III PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1284 INNOVATION DR STE 200
NAPLES FL
34108-2272
US

IV. Provider business mailing address

1284 INNOVATION DR STE 200
NAPLES FL
34108-2272
US

V. Phone/Fax

Practice location:
  • Phone: 800-933-7001
  • Fax:
Mailing address:
  • Phone: 800-933-7001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number043433
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: