Provider Demographics
NPI:1194847590
Name:BORGHI, JAMIE THERESA (PTA)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:THERESA
Last Name:BORGHI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11409 HAWICK PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-7908
Mailing Address - Country:US
Mailing Address - Phone:941-993-6109
Mailing Address - Fax:
Practice Address - Street 1:11730 MILLBROOK RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-3618
Practice Address - Country:US
Practice Address - Phone:941-993-6109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA20221282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital