Healthcare Provider Details

I. General information

NPI: 1245160175
Provider Name (Legal Business Name): LOUIS MICHAEL SCAGNELLI III PT, DPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N CONGRESS AVE STE 411
DELRAY BEACH FL
33445-4640
US

IV. Provider business mailing address

955 DOTTEREL RD APT 2107
DELRAY BEACH FL
33444-2049
US

V. Phone/Fax

Practice location:
  • Phone: 561-638-1078
  • Fax:
Mailing address:
  • Phone: 732-737-5354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT44720
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: