Provider Demographics
NPI:1265857247
Name:DELEANU, DAN ALEXANDER (PHYSICAL THERAPIST A)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:ALEXANDER
Last Name:DELEANU
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 GULF BREEZE BLVD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-7213
Mailing Address - Country:US
Mailing Address - Phone:941-492-7185
Mailing Address - Fax:941-492-7185
Practice Address - Street 1:427 GULF BREEZE BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-7213
Practice Address - Country:US
Practice Address - Phone:941-492-7185
Practice Address - Fax:941-492-7185
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1538225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant