Provider Demographics
NPI:1508975186
Name:SERIANNI, RICHARD DOMINICK (DPT)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DOMINICK
Last Name:SERIANNI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2800 E COMMERCIAL BLVD
Mailing Address - Street 2:SUITE #207
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4229
Mailing Address - Country:US
Mailing Address - Phone:954-491-2021
Mailing Address - Fax:954-622-9791
Practice Address - Street 1:2800 E COMMERCIAL BLVD
Practice Address - Street 2:SUITE #207
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4229
Practice Address - Country:US
Practice Address - Phone:954-491-2021
Practice Address - Fax:954-622-9791
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT21205OtherLICENSE #
FLPT21205OtherLICENSE #