Provider Demographics
NPI:1518505379
Name:DELSIGNORE, RYAN (DPT)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:DELSIGNORE
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 1:117 S WESTLAND AVE # D
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-1778
Mailing Address - Country:US
Mailing Address - Phone:941-706-5210
Mailing Address - Fax:
Practice Address - Street 1:550 62ND ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-1533
Practice Address - Country:US
Practice Address - Phone:727-347-6151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL35339225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist