Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derek Marc Provencher, PT, DPT

Individual provider Physical Therapist · NPI 1114609245

Derek Marc Provencher, PT, DPT is a Physical Therapist in Tampa, Florida. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

16037B Tampa Palms Blvd W
Tampa, FL 33647-2001
Phone: (813) 542-8188
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PTT40333

Record details

NPI number1114609245
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedAugust 7, 2023
Last updated in NPPESAugust 15, 2023
Certification dateAugust 15, 2023

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