Provider Demographics
NPI:1467075937
Name:FELDMAN, JEREMY ERIC (DPT)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:ERIC
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12157 NW 32ND CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3211
Mailing Address - Country:US
Mailing Address - Phone:774-239-3960
Mailing Address - Fax:
Practice Address - Street 1:202 PROVIDENCE MINE RD STE 206
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2946
Practice Address - Country:US
Practice Address - Phone:530-265-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT298261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist