Provider Demographics
NPI:1558971176
Name:STERMER, JACLYN MICHELE (DPT)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:MICHELE
Last Name:STERMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 SE 3RD AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1193
Mailing Address - Country:US
Mailing Address - Phone:954-256-9052
Mailing Address - Fax:
Practice Address - Street 1:805 SE 3RD AVE STE 2
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1193
Practice Address - Country:US
Practice Address - Phone:954-256-9052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL396822251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic