Provider Demographics
NPI:1740735281
Name:WERNER, ANDRZEJ (PT)
Entity Type:Individual
Prefix:
First Name:ANDRZEJ
Middle Name:
Last Name:WERNER
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 1:5801 BRADEN RUN
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-9402
Mailing Address - Country:US
Mailing Address - Phone:941-727-1500
Mailing Address - Fax:941-727-1509
Practice Address - Street 1:5801 BRADEN RUN
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-9402
Practice Address - Country:US
Practice Address - Phone:941-727-1500
Practice Address - Fax:941-727-1509
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31630225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist