Provider Demographics
NPI:1508303991
Name:NAIMAN, DAVID (PTA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:NAIMAN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 SE BLOXHAM WAY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-1569
Mailing Address - Country:US
Mailing Address - Phone:561-801-3944
Mailing Address - Fax:
Practice Address - Street 1:2505 METROCENTRE BLVD
Practice Address - Street 2:SUITE 20E
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3114
Practice Address - Country:US
Practice Address - Phone:561-689-2774
Practice Address - Fax:561-242-0951
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA19323225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant