Healthcare Provider Details

I. General information

NPI: 1023736550
Provider Name (Legal Business Name): DKB HEALTH LLC FYZICAL THERAPY AND BALANCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 11/23/2022
Certification Date: 11/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 PARK ST N STE 101
ST PETERSBURG FL
33709-4030
US

IV. Provider business mailing address

1136 19TH AVE N
ST PETERSBURG FL
33704-4146
US

V. Phone/Fax

Practice location:
  • Phone: 727-388-4688
  • Fax: 727-388-6887
Mailing address:
  • Phone: 727-504-5655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL J PLANTE
Title or Position: OWNER/MANAGER
Credential:
Phone: 277-388-4688