Provider Demographics
NPI:1265580591
Name:YZER, JEAN ANN (PT)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:ANN
Last Name:YZER
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 1:275 NW 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4061
Mailing Address - Country:US
Mailing Address - Phone:954-438-5655
Mailing Address - Fax:
Practice Address - Street 1:275 NW 107TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-4061
Practice Address - Country:US
Practice Address - Phone:954-438-5655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT9648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAF386ZOtherMEDICARE LEGACY
FLAF386ZOtherMEDICARE LEGACY