Provider Demographics
NPI:1285684589
Name:SIGNORETTI, ANTHONY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:SIGNORETTI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 E HIGHWAY 44
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-4444
Mailing Address - Country:US
Mailing Address - Phone:352-563-5055
Mailing Address - Fax:352-563-5069
Practice Address - Street 1:912 E HIGHWAY 44
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-4444
Practice Address - Country:US
Practice Address - Phone:352-563-5055
Practice Address - Fax:352-563-5069
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT17723225100000X
2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY047EMedicare PIN