Provider Demographics
NPI:1053661355
Name:BUFFINGTON, PETER (DPT)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:BUFFINGTON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4098 LIBRA DR STE 114
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32816-8026
Mailing Address - Country:US
Mailing Address - Phone:407-823-0377
Mailing Address - Fax:407-823-1897
Practice Address - Street 1:4098 LIBRA DR STE 114
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816-4501
Practice Address - Country:US
Practice Address - Phone:407-823-0377
Practice Address - Fax:407-823-1897
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27565225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist