Provider Demographics
NPI:1699521609
Name:DE VERA, FELIX DANIEL PERDIDO (PT, DPT)
Entity type:Individual
Prefix:
First Name:FELIX DANIEL
Middle Name:PERDIDO
Last Name:DE VERA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 STAGS LEAP CT
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-6326
Mailing Address - Country:US
Mailing Address - Phone:301-547-5108
Mailing Address - Fax:
Practice Address - Street 1:14 STAGS LEAP CT
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-6326
Practice Address - Country:US
Practice Address - Phone:301-547-5108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25435225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist