MEDICARE: JASMINE CAGANAP ANGELES PT, 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
1	225100000X	Physical Therapist		VA
2	225100000X	Physical Therapist	2305216410	VA

General Provider Information

NPI Number	:	1205675113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE CAGANAP ANGELES PT, DPT

Provider Business Mailing Address
First Line	:	7106 FOXS LAIR CT
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23518-4435
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 N MILITARY HWY
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-2227
Country	:	US
Telephone Number	:	757-961-5888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2024
Last Update Date	:	10/22/2024

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