Provider Demographics
NPI:1811127467
Name:TANEN, MEREDITH JOY (DPT)
Entity type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:JOY
Last Name:TANEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:MEREDITH
Other - Middle Name:JOY
Other - Last Name:POLIRER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:106 PONCE DE LEON ST
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1213
Mailing Address - Country:US
Mailing Address - Phone:954-379-0300
Mailing Address - Fax:954-379-0301
Practice Address - Street 1:762 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-5767
Practice Address - Country:US
Practice Address - Phone:954-379-0300
Practice Address - Fax:954-379-0301
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23054225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist