Provider Demographics
NPI:1023358587
Name:ESTORCO, JOHN VAR ANDOY (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN VAR
Middle Name:ANDOY
Last Name:ESTORCO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12650 ALLENDALE CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4697
Mailing Address - Country:US
Mailing Address - Phone:239-850-1891
Mailing Address - Fax:239-561-1310
Practice Address - Street 1:14630 PALM BEACH BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-2333
Practice Address - Country:US
Practice Address - Phone:239-690-3100
Practice Address - Fax:239-693-3200
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist