Provider Demographics
NPI:1386079879
Name:GERMAN, JOHN DANIEL (BA, CPRP)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DANIEL
Last Name:GERMAN
Suffix:
Gender:M
Credentials:BA, CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 30TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-2625
Mailing Address - Country:US
Mailing Address - Phone:727-823-4324
Mailing Address - Fax:727-822-6240
Practice Address - Street 1:445 31ST ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7605
Practice Address - Country:US
Practice Address - Phone:727-821-4819
Practice Address - Fax:727-822-6240
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL160039OtherCERTIFIIED PSYCHIATRIC REHABILIATION PRACTIONER (CPRP)