Provider Demographics
NPI:1770838831
Name:HAROON, JUSTINE (DPT)
Entity Type:Individual
Prefix:
First Name:JUSTINE
Middle Name:
Last Name:HAROON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 E OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1814
Mailing Address - Country:US
Mailing Address - Phone:954-565-0075
Mailing Address - Fax:
Practice Address - Street 1:2840 E OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1814
Practice Address - Country:US
Practice Address - Phone:954-565-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTT27476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist