Healthcare Provider Details

I. General information

NPI: 1104733278
Provider Name (Legal Business Name): NERLINE JOSEPH PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2521 NE 3RD AVE
POMPANO BEACH FL
33064-3844
US

IV. Provider business mailing address

2521 NE 3RD AVE
POMPANO BEACH FL
33064-3844
US

V. Phone/Fax

Practice location:
  • Phone: 954-560-0373
  • Fax:
Mailing address:
  • Phone: 954-560-0373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number33641
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: