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NPI Code Detail

MEDICARE: JACQUELYN MIGUELINO DPT

MEDICARE: JACQUELYN MIGUELINO DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT030011PA

General Provider Information

NPI Number : 1083372437
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELYN MIGUELINO DPT
Provider Business Mailing Address
First Line : 3680 INDIAN QUEEN LN APT 2
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19129-1525
Country : US
Telephone Number : 347-263-0158
Fax Number :
Provider Business Practice Location Address
First Line : 790 E MARKET ST STE 290
Second Line :
City : WEST CHESTER
State : PA
Zip : 19382-4891
Country : US
Telephone Number : 610-696-3305
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2021
Last Update Date : 01/21/2026

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