Provider Demographics
NPI:1932249331
Name:SORRENTINO, DANIEL ROCCO (PT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROCCO
Last Name:SORRENTINO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14612 CANOPY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-3348
Mailing Address - Country:US
Mailing Address - Phone:813-758-2452
Mailing Address - Fax:
Practice Address - Street 1:14100 FIVAY RD
Practice Address - Street 2:SUITE 210
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7180
Practice Address - Country:US
Practice Address - Phone:727-869-9479
Practice Address - Fax:727-861-7135
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 19408225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist