Provider Demographics
NPI:1295814846
Name:CHOKRAN, DEBBIE ANNE (PTA)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:ANNE
Last Name:CHOKRAN
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 1:5662 SW ORCHID BAY DR
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-8523
Mailing Address - Country:US
Mailing Address - Phone:772-359-3272
Mailing Address - Fax:772-878-5030
Practice Address - Street 1:1680 SW SAINT LUCIE WEST BLVD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1927
Practice Address - Country:US
Practice Address - Phone:772-878-3322
Practice Address - Fax:772-878-5030
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA18932225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant