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General NPI Number Information
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NPI Number | 1396409546
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Entity Type | Individual
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Provider Name | DIANE HEESE DEVOS PT
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Gender | Female
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Dates
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Enumeration Date | 10/25/2021
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 1959 N HONORE AVE
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City | SARASOTA
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State | FL
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Zip | 34235-9117
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Country | US
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Telephone | 941-462-3980
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Fax |
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Provider Business Mailing Address
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Address Line | 8804 17TH AVENUE CIR NW
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City | BRADENTON
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State | FL
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Zip | 34209-8158
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Country | US
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Telephone | 941-741-1870
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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 | PT3208
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License Number State | FL
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