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NPI Code Detail

MEDICARE: GERALDINE NUEVO

MEDICARE: GERALDINE NUEVO
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 TherapistPT11846FL

General Provider Information

NPI Number : 1861712820
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERALDINE NUEVO
Provider Business Mailing Address
First Line : 105 N 5TH AVE
Second Line :
City : MADILL
State : OK
Zip : 73446-1200
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1203 E 22ND AVE
Second Line :
City : TAMPA
State : FL
Zip : 33605-1719
Country : US
Telephone Number : 813-229-6901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2010
Last Update Date : 06/01/2010

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Directions to “ GERALDINE NUEVO ” Practice Location

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