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NPI Code Detail

MEDICARE: PARAGON PHYSICAL THERAPY INC

MEDICARE: PARAGON PHYSICAL THERAPY INC
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 Therapist0009493FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11982816435OTHERFLNPI
21619926292OTHERFLNPI
31780896712OTHERFLNPI

General Provider Information

NPI Number : 1619926292
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARAGON PHYSICAL THERAPY INC
Provider Business Mailing Address
First Line : 6015 44TH CT E
Second Line :
City : BRADENTON
State : FL
Zip : 34203-7022
Country : US
Telephone Number : 941-321-3397
Fax Number : 941-739-6028
Provider Business Practice Location Address
First Line : 3920 BEE RIDGE RD
Second Line : BUILDING E, SUITE H
City : SARASOTA
State : FL
Zip : 34233-1207
Country : US
Telephone Number : 941-924-4605
Fax Number : 941-924-4617
Authorized Official
Title or Position : PRESIDENT
Name : DONNABELLE BERTULFO VITUG
Credential : RPT
Telephone Number : 94132313397
Provider Enumeration Date : 05/09/2006
Last Update Date : 10/16/2007

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Directions to “PARAGON PHYSICAL THERAPY INC ” Practice Location

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