Provider Demographics
NPI:1548401367
Name:BISSONNETTE, AIMEE RENEE
Entity Type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:RENEE
Last Name:BISSONNETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 N DIXIE HIGHWAY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334
Mailing Address - Country:US
Mailing Address - Phone:954-771-0498
Mailing Address - Fax:954-771-1069
Practice Address - Street 1:5301 N. DIXIE HIGHWAY SUITE 203
Practice Address - Street 2:MICHAEL T. REILLY & DAVID H. GILBERT, MD, PA
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334
Practice Address - Country:US
Practice Address - Phone:954-771-3334
Practice Address - Fax:954-771-1069
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL190942251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic