Healthcare Provider Details

I. General information

NPI: 1265108583
Provider Name (Legal Business Name): GISELLE PADRIGONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 E SEMORAN BLVD STE 107
APOPKA FL
32703-5610
US

IV. Provider business mailing address

812 BALTIMORE DR
ORLANDO FL
32810-5515
US

V. Phone/Fax

Practice location:
  • Phone: 407-880-7772
  • Fax:
Mailing address:
  • Phone: 407-233-8969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: