Provider Demographics
NPI:1356627285
Name:LEPERVANCHE, BELINDA MERCEDES (DPT)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:MERCEDES
Last Name:LEPERVANCHE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:BELINDA
Other - Middle Name:MERCEDES
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:17842 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2806
Mailing Address - Country:US
Mailing Address - Phone:954-704-3384
Mailing Address - Fax:954-435-0624
Practice Address - Street 1:17842 NW 2ND ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2806
Practice Address - Country:US
Practice Address - Phone:954-704-3384
Practice Address - Fax:954-435-0624
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23752225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist