Basic Information
Provider Information
NPI: 1497062970
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FARNESS
FirstName: PARASCHIVA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8477 S SUNCOAST BLVD
Address2:  
City: HOMOSASSA
State: FL
PostalCode: 344465028
CountryCode: US
TelephoneNumber: 3523821141
FaxNumber:  
Practice Location
Address1: 4410 GULF BREEZE PKWY
Address2:  
City: GULF BREEZE
State: FL
PostalCode: 325638130
CountryCode: US
TelephoneNumber: 8509344306
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/07/2010
LastUpdateDate: 09/07/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000XPTA 21745FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


Home