Healthcare Provider Details

I. General information

NPI: 1962181792
Provider Name (Legal Business Name): LUIS FERRER PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2328 HANCOCK BRIDGE PKWY
CAPE CORAL FL
33990-1459
US

IV. Provider business mailing address

1141 SW 2ND ST
CAPE CORAL FL
33991-1508
US

V. Phone/Fax

Practice location:
  • Phone: 239-574-7557
  • Fax:
Mailing address:
  • Phone: 239-691-0114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: