Provider Demographics
NPI:1386917623
Name:DAMALERIO, ADRIANO MANIGO JR (RPT)
Entity type:Individual
Prefix:MR
First Name:ADRIANO
Middle Name:MANIGO
Last Name:DAMALERIO
Suffix:JR
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 N PINE ISLAND RD
Mailing Address - Street 2:APT # 404
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6520
Mailing Address - Country:US
Mailing Address - Phone:954-315-8109
Mailing Address - Fax:
Practice Address - Street 1:4041 N PINE ISLAND RD
Practice Address - Street 2:APT # 404
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6520
Practice Address - Country:US
Practice Address - Phone:954-260-9015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 27177225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist