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General NPI Number Information
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NPI Number | 1275562183
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Entity Type | Individual
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Provider Name | LAWRENCE A BERTOLINO P.T.
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Gender | Male
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 06/08/2017
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Provider Practice Location Address
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Address Line | 5023 RINGWOOD MDW BLDG F
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City | SARASOTA
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State | FL
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Zip | 34235-2035
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Country | US
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Telephone | 941-360-9706
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Fax | 941-360-8032
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Provider Business Mailing Address
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Address Line | 8913 BERNBERRY STREET
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City | SARASOTA
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State | FL
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Zip | 34240
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Country | US
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Telephone | 941-350-0006
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Fax | 941-379-8684
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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 | PT20421
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License Number State | FL
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