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General NPI Number Information
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NPI Number | 1487293015
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Entity Type | Individual
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Provider Name | JERROLD OFIANA DPT
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Gender | Male
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Dates
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Enumeration Date | 12/30/2019
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 2735 VULDARNO LN
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City | MELBOURNE
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State | FL
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Zip | 32940-7695
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Country | US
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Telephone | 513-504-7911
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Fax | 866-337-2549
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Provider Business Mailing Address
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Address Line | 109 ROSEWOOD DR
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City | STREAMWOOD
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State | IL
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Zip | 60107-1581
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Country | US
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Telephone |
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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 | 070024905
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT37705
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License Number State | FL
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