Provider Demographics
NPI:1457136756
Name:ENCARNACION, MERISSA (DPT)
Entity Type:Individual
Prefix:
First Name:MERISSA
Middle Name:
Last Name:ENCARNACION
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 N DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1845
Mailing Address - Country:US
Mailing Address - Phone:561-961-4726
Mailing Address - Fax:561-621-3417
Practice Address - Street 1:1840 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1845
Practice Address - Country:US
Practice Address - Phone:561-961-4726
Practice Address - Fax:561-621-3417
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20486225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist