Provider Demographics
NPI: | 1447298948 |
---|---|
Name: | PICARD, VEERLE GEORGETTE (PT) |
Entity type: | Individual |
Prefix: | |
First Name: | VEERLE |
Middle Name: | GEORGETTE |
Last Name: | PICARD |
Suffix: | |
Gender: | F |
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: | 3920 BEE RIDGE RD |
Mailing Address - Street 2: | BLDG E, UNIT G |
Mailing Address - City: | SARASOTA |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 34233-1207 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 941-925-2700 |
Mailing Address - Fax: | 941-925-7744 |
Practice Address - Street 1: | 3920 BEE RIDGE RD |
Practice Address - Street 2: | BLDG E, UNIT G |
Practice Address - City: | SARASOTA |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34233-1207 |
Practice Address - Country: | US |
Practice Address - Phone: | 941-925-2700 |
Practice Address - Fax: | 941-925-7744 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-06-04 |
Last Update Date: | 2017-01-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | PT15224 | 225100000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | 7611346 | Other | GHI INDIV PROV NUM |
FL | Y065M | Other | BCBS INDIV PROV NUM |
FL | 7611346 | Other | GHI INDIV PROV NUM |