Healthcare Provider Details

I. General information

NPI: 1013498005
Provider Name (Legal Business Name): JOYCE HEGEMAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1959 N HONORE AVE
SARASOTA FL
34235-9117
US

IV. Provider business mailing address

1959 N HONORE AVE
SARASOTA FL
34235-9117
US

V. Phone/Fax

Practice location:
  • Phone: 941-462-3980
  • Fax: 941-371-6827
Mailing address:
  • Phone: 941-462-3980
  • Fax: 941-371-6827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT31320
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: