Provider Demographics
NPI:1164155669
Name:PRANZONI, DARIN (PT, ATC)
Entity Type:Individual
Prefix:
First Name:DARIN
Middle Name:
Last Name:PRANZONI
Suffix:
Gender:M
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 HEARTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-8588
Mailing Address - Country:US
Mailing Address - Phone:321-698-8311
Mailing Address - Fax:
Practice Address - Street 1:634 BARNES BLVD STE 202
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5217
Practice Address - Country:US
Practice Address - Phone:321-351-2700
Practice Address - Fax:321-351-2727
Is Sole Proprietor?:No
Enumeration Date:2022-07-03
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL1012255A2300X
FLPT9298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer