MEDICARE: MS. PATRICIA PUNTUMAPANITCH RD

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	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian	LDN2918	MA
2	133V00000X	Registered Dietitian	13217	FL

General Provider Information

NPI Number	:	1588971832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA PUNTUMAPANITCH RD

Provider Business Mailing Address
First Line	:	31 SW 14TH AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-1411
Country	:	US
Telephone Number	:	508-280-1228
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 SW 14TH AVE
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-1411
Country	:	US
Telephone Number	:	508-280-1228
Fax Number	:

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

Provider Enumeration Date	:	09/08/2010
Last Update Date	:	10/09/2025

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