Healthcare Provider Details

I. General information

NPI: 1508801481
Provider Name (Legal Business Name): ANGELO ANASTASSIOS STEFANIDES PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 TAMIAMI TRL N STE 302
NAPLES FL
34103-4435
US

IV. Provider business mailing address

15838 SECOYA RESERVE CIR
NAPLES FL
34110-1091
US

V. Phone/Fax

Practice location:
  • Phone: 973-768-7247
  • Fax: 855-461-3576
Mailing address:
  • Phone: 973-768-7247
  • Fax: 855-461-3576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00884800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT35854
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: