Provider Demographics
NPI:1497851992
Name:DELLOCONO, VALERIE LYNN (DPT)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:DELLOCONO
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 1:6196 LAKE ELLA RD
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-8216
Mailing Address - Country:US
Mailing Address - Phone:908-433-7054
Mailing Address - Fax:
Practice Address - Street 1:184 E REDSTONE AVE STE A
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-5372
Practice Address - Country:US
Practice Address - Phone:850-689-3127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT25276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ051493Medicare ID - Type Unspecified