Deandra Marie Bucknor, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT34485 Issued in FL

Practice address

11947 Southern Blvd
Royal Palm Beach, FL 33411-7619

Phone

(561) 204-2213

Fax

(561) 204-2218

NPI assigned

Apr 2, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1205398906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7828 NW 71ST WAY",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330672207",
            "telephone_number": "954-609-1897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11947 SOUTHERN BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334117619",
            "telephone_number": "561-204-2213",
            "fax_number": "561-204-2218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12251 Taft St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330261956",
            "country_code": "US",
            "telephone_number": "954-743-1918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKNOR",
        "first_name": "DEANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT34485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John L. Brown III, PT
• Bruce L. Elkind, DDS, PA
• Lisa Kay Brundrett, DO
• Bryan M Dawkins MD PA (Impact MD)
• Tamekia Bryant
• Marie Evelyne Buissereth, FNP
• Marcus Burke
• Jenna Burns, PA-C
• Shannon Burt
• Steven J. Bussell, D.M.D.

• Physical Therapist in Royal Palm Beach, FL
• Providers in Royal Palm Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.