MEDICARE: JOSEPH R NOEL PT

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	PT6617	FL
2	2251X0800X	Orthopedic Physical Therapist	PT6617	FL

General Provider Information

NPI Number	:	1417017500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH R NOEL PT

Provider Business Mailing Address
First Line	:	13020 N TELECOM PKWY
Second Line	:	UNIT 202
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-0925
Country	:	US
Telephone Number	:	813-978-9700
Fax Number	:	813-558-6186

Provider Business Practice Location Address
First Line	:	1212 E WHITING ST
Second Line	:	APT 202
City	:	TAMPA
State	:	FL
Zip	:	33602-4106
Country	:	US
Telephone Number	:	813-505-9328
Fax Number	:

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	07/21/2016

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