Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DEREK MARC PROVENCHER, PT, DPT

Active

DEREK MARC PROVENCHER, PT, DPT is a Physical Therapy Assistant healthcare provider located in TAMPA, Florida. NPI 1114609245 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · TAMPA, FL

Registration Details

NPI Number: 1114609245
Provider Type: Individual
Gender: Male
NPI Issued: Aug 7, 2023 (3.0240395004714 yrs)
Last Updated: Aug 15, 2023
License: PTT40333

Practice Information

Address: 16037B TAMPA PALMS BLVD W

TAMPA, FL, 336472001
Browse FL providers · Browse ZIP 33647
Phone: 8135428188
Primary Specialty: Physical Therapy Assistant
225100000X

Other Physical Therapy Assistant Providers in TAMPA, FL

Name	Credential	NPI
SWAPNA GANDRE	P.T.	1104824713
PARINITA SHANTA SMITH	P.T.	1700886538
PHILIP WALTER SMITH	P.T.	1598765976
NORMAN H. SCHLACT	M.P.T.	1790771905
MR. JOHN ALLEN HISAMOTO	P.T.	1962490938
MARIAN ELIZABETH MAURIN	P.T.	1669460812

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.