Provider Demographics
NPI:1033284682
Name:VENUTO, PAUL (PT)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:VENUTO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 W CAMINO REAL
Mailing Address - Street 2:101
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5511
Mailing Address - Country:US
Mailing Address - Phone:561-417-9563
Mailing Address - Fax:561-417-9564
Practice Address - Street 1:7200 W CAMINO REAL
Practice Address - Street 2:101
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5511
Practice Address - Country:US
Practice Address - Phone:561-417-9563
Practice Address - Fax:561-417-9564
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18030225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist