Provider Demographics
NPI:1053668863
Name:RONIS, DEBORAH LYNN (DSC, PT, MBA)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LYNN
Last Name:RONIS
Suffix:
Gender:F
Credentials:DSC, PT, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5586 AMOROSO DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-3402
Mailing Address - Country:US
Mailing Address - Phone:239-940-9568
Mailing Address - Fax:239-437-1888
Practice Address - Street 1:5586 AMOROSO DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-3402
Practice Address - Country:US
Practice Address - Phone:239-940-9568
Practice Address - Fax:239-437-1888
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5491225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics