Provider Demographics
NPI:1982652913
Name:SIMPSON, TERESA D (PT)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:D
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 36TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4811
Mailing Address - Country:US
Mailing Address - Phone:772-567-8040
Mailing Address - Fax:772-567-8420
Practice Address - Street 1:1345 36TH ST
Practice Address - Street 2:STE A
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4811
Practice Address - Country:US
Practice Address - Phone:772-567-8040
Practice Address - Fax:772-567-8420
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 22087225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU6493ZMedicare ID - Type Unspecified