IndividualActive
Mark Documento, RPT
NPI 1316104292 · Physical Therapist · Port Saint Lucie, FL
Provider details
- NPI number
- 1316104292
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- RPT
- Sex
- Male
- Sole proprietor
- No
- License
- PT20821 (FL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
266 Nw Peacock Blvd
Suite 2-204 Bldg. 2
Port Saint Lucie, FL 34986-2271
Phone: (772) 408-6630
Fax: (772) 408-6750
Street-level locationGet directions
Mailing address
Po Box 7666
Port Saint Lucie, FL 34985-7666
Registry dates
- Enumerated
- 2008-05-19
- Last updated
- 2009-04-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.