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General NPI Number Information
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NPI Number | 1891279071
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Entity Type | Individual
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Provider Name | NOREEN SIDHOM PT DPT
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Gender | Female
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Dates
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Enumeration Date | 09/24/2018
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 2868 S ALAFAYA TRL STE 100
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City | ORLANDO
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State | FL
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Zip | 32828-7974
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Country | US
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Telephone | 407-214-0100
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Fax | 908-436-1084
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Provider Business Mailing Address
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Address Line | 1122 AUGUSTUS DR
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City | DAVENPORT
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State | FL
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Zip | 33896-8630
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Country | US
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Telephone | 732-713-7403
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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 | 40QA1823000
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License Number State | NJ
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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 | PT36276
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License Number State | FL
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