Individual
MS. DEBRA DEPTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
60 PERDIDO KEY CT, PONTE VEDRA, FL 32081-0545
(904) 217-3951
Mailing address
60 PERDIDO KEY CT, PONTE VEDRA, FL 32081-0545
(904) 217-3951
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
010243
NY
2251P0200X
Pediatric Physical Therapist
Primary
PT25492
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02683750
—
NY
Enumeration date
05/24/2006
Last updated
03/23/2016
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