Provider Demographics
NPI:1881899938
Name:GENEVIEVE DUREMDEZ FLEXICARE PHYSICAL THERAPY
Entity type:Organization
Organization Name:GENEVIEVE DUREMDEZ FLEXICARE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:GENEVIEVE
Authorized Official - Middle Name:DACOCO
Authorized Official - Last Name:DUREMDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-751-7505
Mailing Address - Street 1:3701 54TH DR W BLDG M-101
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3558
Mailing Address - Country:US
Mailing Address - Phone:941-751-7505
Mailing Address - Fax:941-753-6961
Practice Address - Street 1:3701 54TH DR. W. BLDG. M-101
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210
Practice Address - Country:US
Practice Address - Phone:941-751-7505
Practice Address - Fax:941-753-6961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2058AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER