Provider Demographics
NPI:1568418705
Name:RES, GIORGIO G (DC, PT)
Entity Type:Individual
Prefix:DR
First Name:GIORGIO
Middle Name:G
Last Name:RES
Suffix:
Gender:M
Credentials:DC, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 37TH PL
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4502
Mailing Address - Country:US
Mailing Address - Phone:772-978-7377
Mailing Address - Fax:772-978-7378
Practice Address - Street 1:1715 37TH PL
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4502
Practice Address - Country:US
Practice Address - Phone:772-978-7377
Practice Address - Fax:772-978-7378
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9113111N00000X
FLPT22446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL60994OtherBCBS
FLY106GOtherBCBS
FLU8035ZMedicare PIN
FL60994ZMedicare PIN
FLY106GOtherBCBS