Individual
MR. DEOGENES DE ASAS ENTERIA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3201 W. COMMERCIAL BLVD., SUITE 116, FORT LAUDERDAXLE, FL 33309-3440
(954) 332-4445
(954) 332-4340
Mailing address
3290 NORTH RIDGE ROAD EXECUTIVE CENTER II, SUITE 290, ELLICOTT CITY, MD 21043-3655
(410) 750-9006
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT018712
PA
Other
Enumeration date
11/06/2007
Last updated
11/06/2007
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