Provider Demographics
NPI:1265917462
Name:GIRGIS, ANTONY (DPT)
Entity type:Individual
Prefix:
First Name:ANTONY
Middle Name:
Last Name:GIRGIS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1181 BLACKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4518
Mailing Address - Country:US
Mailing Address - Phone:407-292-0073
Mailing Address - Fax:407-292-9666
Practice Address - Street 1:1181 BLACKWOOD AVE
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4518
Practice Address - Country:US
Practice Address - Phone:407-292-0073
Practice Address - Fax:407-292-9666
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34051225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist