Provider Demographics
NPI:1134522451
Name:PEPE, JANIFER (MS,PT)
Entity type:Individual
Prefix:
First Name:JANIFER
Middle Name:
Last Name:PEPE
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RIVERFRONT BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8812
Mailing Address - Country:US
Mailing Address - Phone:941-527-1200
Mailing Address - Fax:
Practice Address - Street 1:101 RIVERFRONT BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8812
Practice Address - Country:US
Practice Address - Phone:941-527-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist