Provider Demographics
NPI:1104252311
Name:WERBER, LAURA C (DPT, PT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:C
Last Name:WERBER
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:C
Other - Last Name:ROGOZINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, PT
Mailing Address - Street 1:32 SE 2ND AVE
Mailing Address - Street 2:APARTMENT 412
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-3601
Mailing Address - Country:US
Mailing Address - Phone:904-553-0475
Mailing Address - Fax:
Practice Address - Street 1:21065 POWERLINE RD
Practice Address - Street 2:SUITE A-2
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2313
Practice Address - Country:US
Practice Address - Phone:561-883-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28573225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1104252311OtherMEDICARE NUMEBR