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NPI Code Detail

MEDICARE: DAVID DESMOND

MEDICARE: DAVID DESMOND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA 20131FL

General Provider Information

NPI Number : 1760538763
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID DESMOND
Provider Business Mailing Address
First Line : 190 W NATIONAL ST
Second Line :
City : HERNANDO
State : FL
Zip : 34442-4899
Country : US
Telephone Number : 352-400-3695
Fax Number :
Provider Business Practice Location Address
First Line : 130 HEIGHTS AVE
Second Line :
City : INVERNESS
State : FL
Zip : 34452-4571
Country : US
Telephone Number : 352-419-6570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 09/01/2015

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Directions to “ DAVID DESMOND ” Practice Location

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