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JEREMY SHAKOURI WYDRA NPI 1497480792


NPI Information

NPI: 1497480792
Provider Name: JEREMY SHAKOURI WYDRA
Classification: Physical Therapist - 2251X0800X
Entity Type: Individual

Specialization: Orthopedic

Address:
4040 WINTER GARDEN VINELAND RD
WINTER GARDEN, FL
ZIP 34787
Phone: (407) 573-3361
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Jeremy Shakouri Wydra is an orthopedic physical therapist in Winter Garden, FL with 2 years of experience. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice. Jeremy Shakouri Wydra NPI is 1497480792. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4040 WINTER GARDEN VINELAND RD
WINTER GARDEN, FL
ZIP 34787-502
Phone: (407) 573-3361
Fax: (407) 395-8309

The enumeration date for this NPI number is 7/20/2022 and was last updated on 6/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225100000XPhysical TherapistNo
2225100000XPhysical Therapist29148MARYLANDNo
32251X0800XPhysical TherapistOrthopedicPT39007FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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