Provider Demographics
NPI:1487667010
Name:HARDT, BETH MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:MARIE
Last Name:HARDT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6725 SLOANE PL
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-8314
Mailing Address - Country:US
Mailing Address - Phone:239-777-1747
Mailing Address - Fax:239-348-0552
Practice Address - Street 1:6725 SLOANE PL
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-8314
Practice Address - Country:US
Practice Address - Phone:239-777-1747
Practice Address - Fax:239-348-0552
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2015-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11784225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL884138100Medicaid