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NPI Code Detail

MEDICARE: NICOLE Y PEGARIDO DPT

MEDICARE:   NICOLE Y PEGARIDO  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
1225100000XPhysical TherapistPT34170FL

General Provider Information

NPI Number : 1639647274
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE Y PEGARIDO DPT
Provider Business Mailing Address
First Line : PO BOX 370
Second Line :
City : FORTSON
State : GA
Zip : 31808-0370
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6775 CHOPRA TER STE 300
Second Line :
City : ORLANDO
State : FL
Zip : 32827-5811
Country : US
Telephone Number : 407-965-4114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2018
Last Update Date : 09/05/2023

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Directions to “ NICOLE Y PEGARIDO DPT” Practice Location

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