Provider Demographics
NPI:1144060633
Name:REGISTER-PELHAM, DEBORAH ELAINE
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ELAINE
Last Name:REGISTER-PELHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 49TH ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-5331
Mailing Address - Country:US
Mailing Address - Phone:727-546-4661
Mailing Address - Fax:
Practice Address - Street 1:8701 49TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-5331
Practice Address - Country:US
Practice Address - Phone:727-546-4661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA22607225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant