MEDICARE: MICHELE MAGNESS 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	42669	FL
2	222Q00000X	Developmental Therapist	42669	FL

General Provider Information

NPI Number	:	1508153800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE MAGNESS PT

Provider Business Mailing Address
First Line	:	4311 PELICAN BLVD
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-7864
Country	:	US
Telephone Number	:	502-523-1741
Fax Number	:

Provider Business Practice Location Address
First Line	:	4311 PELICAN BLVD
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-7864
Country	:	US
Telephone Number	:	502-523-1741
Fax Number	:

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

Provider Enumeration Date	:	07/07/2011
Last Update Date	:	12/11/2025

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Directions to “ MICHELE MAGNESS PT” Practice Location

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