Provider Demographics
NPI:1043360001
Name:VENNETT, PATRICIA ANN (PT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:VENNETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8462 EGRET MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-1556
Mailing Address - Country:US
Mailing Address - Phone:561-776-6275
Mailing Address - Fax:
Practice Address - Street 1:130 JOHN F KENNEDY DR
Practice Address - Street 2:SUITE 132
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33462-1141
Practice Address - Country:US
Practice Address - Phone:561-969-6125
Practice Address - Fax:561-964-5301
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY913MOtherBCBS OF FL PROVIDER #
FLY913MOtherBCBS OF FL PROVIDER #