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General NPI Number Information
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NPI Number | 1972388304
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Entity Type | Individual
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Provider Name | CORY HEGEDUS PT
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Gender | Male
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 3301 32ND AVE S APPT 364
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City | ST. PETERSBURG
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State | FL
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Zip | 33712
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Country | US
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Telephone | 412-596-2829
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Fax |
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Provider Business Mailing Address
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Address Line | 5901 SUN BLVD STE 110
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City | ST PETERSBURG
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State | FL
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Zip | 33715-1165
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Country | US
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Telephone | 412-596-2829
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT40689
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License Number State | FL
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