Provider Demographics
NPI:1558763979
Name:BELL, JERMAINE (PT)
Entity type:Individual
Prefix:
First Name:JERMAINE
Middle Name:
Last Name:BELL
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 1:11037 HARBOUR SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1244
Mailing Address - Country:US
Mailing Address - Phone:561-577-3961
Mailing Address - Fax:
Practice Address - Street 1:3319 FL-7 STE 310
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449
Practice Address - Country:US
Practice Address - Phone:561-795-5870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
FLPT29698225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty