Provider Demographics
NPI:1881627412
Name:SPERRY, JOSHUA JAMES (MPT, MBA)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JAMES
Last Name:SPERRY
Suffix:
Gender:M
Credentials:MPT, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W ROBERTSON ST
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5115
Mailing Address - Country:US
Mailing Address - Phone:813-785-6395
Mailing Address - Fax:813-651-3911
Practice Address - Street 1:305 W ROBERTSON ST
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5115
Practice Address - Country:US
Practice Address - Phone:813-785-6395
Practice Address - Fax:813-651-3911
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT193012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT19301OtherFL PHYS. THERAPY LICENSE