Provider Demographics
NPI:1548528136
Name:LONGOBARDI, ANTHONY GENNARO (PT)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:GENNARO
Last Name:LONGOBARDI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 58TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35222-4131
Mailing Address - Country:US
Mailing Address - Phone:850-377-9712
Mailing Address - Fax:
Practice Address - Street 1:1349 58TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35222-4131
Practice Address - Country:US
Practice Address - Phone:850-377-9712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist