Provider Demographics
NPI:1962704684
Name:BARTOLUCCI, PATRICIA MARY (RPT)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARY
Last Name:BARTOLUCCI
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:INDIAN ROCKS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33785-3725
Mailing Address - Country:US
Mailing Address - Phone:518-248-0317
Mailing Address - Fax:727-238-8088
Practice Address - Street 1:123 11TH AVE
Practice Address - Street 2:
Practice Address - City:INDIAN ROCKS BEACH
Practice Address - State:FL
Practice Address - Zip Code:33785-3725
Practice Address - Country:US
Practice Address - Phone:518-248-0317
Practice Address - Fax:727-238-8088
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 124352251H1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHuman Factors