Provider Demographics
NPI:1629252697
Name:BARENHOLTZ, DORI FERN (PT)
Entity Type:Individual
Prefix:MS
First Name:DORI
Middle Name:FERN
Last Name:BARENHOLTZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9250 GLADES RD STE 106
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3958
Mailing Address - Country:US
Mailing Address - Phone:561-482-4300
Mailing Address - Fax:561-482-8855
Practice Address - Street 1:9250 GLADES RD STE 106
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3958
Practice Address - Country:US
Practice Address - Phone:561-482-4300
Practice Address - Fax:561-482-8855
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL127712251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12771OtherPHYSICAL THERAPY LICENSE
FL12771OtherPHYSICAL THERAPY LICENSE