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General NPI Number Information
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NPI Number | 1194950923
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Entity Type | Individual
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Provider Name | JANIS LYNN VERDE
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Gender | Female
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 05/22/2009
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Provider Practice Location Address
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Address Line | 2645 E ATLANTIC BLVD
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City | POMPANO BEACH
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State | FL
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Zip | 33062-4939
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Country | US
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Telephone | 305-876-9004
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 551330
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City | FT LAUDERDALE
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State | FL
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Zip | 33355-1330
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Country | US
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Telephone | 305-876-9004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT13611
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT13611
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License Number State | FL
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