Provider Demographics
NPI:1841307758
Name:ARENA, JOHN C (PT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:ARENA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 N FEDERAL HWY
Mailing Address - Street 2:#277
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-1422
Mailing Address - Country:US
Mailing Address - Phone:954-336-7722
Mailing Address - Fax:
Practice Address - Street 1:1007 N FEDERAL HWY
Practice Address - Street 2:#277
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-1422
Practice Address - Country:US
Practice Address - Phone:954-336-7722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT17917OtherLICENSE#