Provider Demographics
NPI:1013057819
Name:FEROGLIA, JEFF DANIEL (ATC,LAT)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:DANIEL
Last Name:FEROGLIA
Suffix:
Gender:M
Credentials:ATC,LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12328 EASTCOVE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-3622
Mailing Address - Country:US
Mailing Address - Phone:305-519-1581
Mailing Address - Fax:
Practice Address - Street 1:934 WILLISTON PARK PT
Practice Address - Street 2:SUITE 1020
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2165
Practice Address - Country:US
Practice Address - Phone:407-829-7311
Practice Address - Fax:407-829-7805
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL#19262255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer