Provider Demographics
NPI:1538261730
Name:WEBER, JORGELINA (PT)
Entity type:Individual
Prefix:
First Name:JORGELINA
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3861 OAKWATER CIR STE 1
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6258
Mailing Address - Country:US
Mailing Address - Phone:407-649-8925
Mailing Address - Fax:407-649-9881
Practice Address - Street 1:3861 OAKWATER CIR STE 1
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6258
Practice Address - Country:US
Practice Address - Phone:407-649-8925
Practice Address - Fax:407-649-9881
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT15962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU4714AMedicare UPIN