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General NPI Number Information
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NPI Number | 1235054503
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Entity Type | Individual
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Provider Name | JACKELINE FUENTES PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 1941 LIMESTONE RD STE 209
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City | WILMINGTON
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State | DE
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Zip | 19808-5400
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Country | US
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Telephone | 302-668-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 2105 OAK ST
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City | WILMINGTON
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State | DE
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Zip | 19808-4832
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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