Active NPI
Adrienne Lee Daisernia, P.T.
- Physical Therapist
- Panama City Beach, FL
National Provider Identifier
1336234673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT18733
- Practice address
- 120 N Richard Jackson Blvd
Suite 30
Panama City Beach, FL 32407-2521 - Phone
- (850) 235-6360
- Fax
- (850) 235-8871
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT18733 | FL | Primary |
Addresses
Primary practice location
120 N Richard Jackson Blvd
Suite 30
Panama City Beach, FL 32407-2521
Mailing address
11605 Sand Castle LN
Panama City Beach, FL 32407-4547
Phone (850) 532-9051
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT18733 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417478400000",
"number": "1336234673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11605 SAND CASTLE LN",
"city": "PANAMA CITY BEACH",
"state": "FL",
"postal_code": "324074547",
"telephone_number": "850-532-9051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 N RICHARD JACKSON BLVD",
"address_2": "SUITE 30",
"city": "PANAMA CITY BEACH",
"state": "FL",
"postal_code": "324072521",
"telephone_number": "850-235-6360",
"fax_number": "850-235-8871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAISERNIA",
"first_name": "ADRIENNE",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2014-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT18733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panama City Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.