Provider Demographics
NPI:1013546324
Name:DEPALMA, GARY L II (DPT)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:L
Last Name:DEPALMA
Suffix:II
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ISLAND WAY # 216
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33767-2216
Mailing Address - Country:US
Mailing Address - Phone:850-512-6357
Mailing Address - Fax:
Practice Address - Street 1:515 CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-2515
Practice Address - Country:US
Practice Address - Phone:727-934-4629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL35587225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist