Provider Demographics
NPI:1780968370
Name:LOMBARDI, JENNIFER ROSEO (DPT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ROSEO
Last Name:LOMBARDI
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 1:2744 NW 28TH TER
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-6028
Mailing Address - Country:US
Mailing Address - Phone:561-212-3129
Mailing Address - Fax:
Practice Address - Street 1:100 JIM MORAN BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1702
Practice Address - Country:US
Practice Address - Phone:954-249-2418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-01
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26854225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist