| Doctor Name: | MR. JEREMY SOLO CAGOCO LIWASAN |
| NPI Number: | 1801142914 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 070017602 |
| Business Practice Address: | 7580 Omni Ln Apt 201 Fort Myers, FL - 339055481 |
| Business Phone Number: | 7168672006 |
| Business Fax Number: | |
| Mailing Address: | 16089 Poppyseed Cir Unit 2008, DELRAY BEACH |
| State: | FL |
| Postal Code: | 334846314 |
| Phone Number: | 7168672006 |
| Fax Number: | |
| NPI Enumeration Date: | 07/25/2012 |
| NPI Last Update Date: | 07/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 070017602 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |