Provider Demographics
NPI:1437896362
Name:DELUNA, JESSE JOEL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:JOEL
Last Name:DELUNA
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 1:5260 STATION WAY BLDG B
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3232
Mailing Address - Country:US
Mailing Address - Phone:941-379-0801
Mailing Address - Fax:
Practice Address - Street 1:5650 GANTT RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3237
Practice Address - Country:US
Practice Address - Phone:941-413-7997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL37317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist