Provider Demographics
NPI:1407971054
Name:REGUEIRO, JANNETTE (PT)
Entity Type:Individual
Prefix:
First Name:JANNETTE
Middle Name:
Last Name:REGUEIRO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JANNETTE
Other - Middle Name:
Other - Last Name:MERCADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16110 ARROWHEAD TRL
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6216
Mailing Address - Country:US
Mailing Address - Phone:407-877-8290
Mailing Address - Fax:
Practice Address - Street 1:1210 BOWMAN ST
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-3144
Practice Address - Country:US
Practice Address - Phone:407-877-8290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6660225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist