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General NPI Number Information
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NPI Number | 1578742771
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Entity Type | Individual
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Provider Name | CHRISTOPHER M. BERTUCCINI MPT
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Gender | Male
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Dates
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Enumeration Date | 10/24/2007
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 405 N WICKHAM RD
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City | MELBOURNE
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State | FL
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Zip | 32935-8626
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Country | US
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Telephone | 321-327-8509
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Fax | 321-327-2130
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Provider Business Mailing Address
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Address Line | 2200 W EAU GALLIE BLVD STE 105
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City | MELBOURNE
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State | FL
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Zip | 32935-3166
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Country | US
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Telephone | 321-255-2828
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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 | 41400
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License Number State | FL
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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 | 40QA00905600
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License Number State | NJ
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