Provider Demographics
NPI:1659629715
Name:DIMAGGIO, FRANK JOSEPH (PT)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JOSEPH
Last Name:DIMAGGIO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2631 E OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1657
Mailing Address - Country:US
Mailing Address - Phone:954-537-5558
Mailing Address - Fax:954-537-7997
Practice Address - Street 1:2631 E OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1657
Practice Address - Country:US
Practice Address - Phone:954-537-5558
Practice Address - Fax:954-537-7997
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT0002323225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist