Provider Demographics
NPI:1902392269
Name:IOFFREDI, DAVIDE (PT)
Entity Type:Individual
Prefix:
First Name:DAVIDE
Middle Name:
Last Name:IOFFREDI
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 1:1825 S OCEAN DR APT 601
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4950
Mailing Address - Country:US
Mailing Address - Phone:306-206-6961
Mailing Address - Fax:
Practice Address - Street 1:378 HILLSBORO TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1836
Practice Address - Country:US
Practice Address - Phone:954-449-0850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT33678208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation