Provider Demographics
NPI:1760530828
Name:CZERWINSKI, DANIEL STEVEN (PT AP)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:STEVEN
Last Name:CZERWINSKI
Suffix:
Gender:M
Credentials:PT AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15121 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:VILLAGE OF PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33176-8054
Mailing Address - Country:US
Mailing Address - Phone:305-962-3240
Mailing Address - Fax:305-235-8724
Practice Address - Street 1:6075 SUNSET DR
Practice Address - Street 2:SUITE 203
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5000
Practice Address - Country:US
Practice Address - Phone:305-962-3240
Practice Address - Fax:305-235-8724
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 3806225100000X
FLAP 461171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY4411YMedicare PIN