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Individual
MR. JOHN ALLEN HISAMOTO
Active
Individual
MR. JOHN ALLEN HISAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5271
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K2780
MEDICARE GROUP NUMBER
—
01
—
Y4306
BLUE CROSS BLUE SHIELD
—
Enumeration date
10/12/2005
Last updated
07/13/2026
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