Provider Demographics
NPI:1366514390
Name:CERE, ANTHONY LEE (PT, DPT, MTC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:LEE
Last Name:CERE
Suffix:
Gender:M
Credentials:PT, DPT, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9750 SW 98TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-6062
Mailing Address - Country:US
Mailing Address - Phone:352-246-5958
Mailing Address - Fax:
Practice Address - Street 1:3951 NW 48TH TER
Practice Address - Street 2:SUITE 111
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7228
Practice Address - Country:US
Practice Address - Phone:352-246-5958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19159225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist